“I recall one patient who presented with some symptoms of ARF, but not enough to make a definitive diagnosis. A couple of days later, while doing my rounds, other symptoms arose. Within minutes, I was able to diagnose definite acute rheumatic fever (ARF) by using the ARF Diagnosis Calculator on my mobile phone. It’s great because the app gives you the ability to make timely and accurate diagnoses. It provides your patient with the best opportunity to receive a positive health outcome.–” – Dr Jamie Hullick, Royal Darwin Hospital

Jamie Hullick is a resident doctor at the Royal Darwin Hospital in the Northern Territory.  As a junior doctor working in the Northern Territory, last year he found himself in the epicentre of ARF and rheumatic heart disease (RHD) case detection in Australia.  We talked to him recently about his time as an intern and his experience using the rheumatic fever and rheumatic heart disease phone app. Derived from The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (2nd edition), the free app, developed by RHDAustralia, includes an ARF diagnosis calculator.

How many cases of acute rheumatic fever did you see last year on your rounds?

I was coming across one case of ARF a week. And those were just the definitive cases that I dealt with; I’m sure there were more. Some doctors who come from metropolitan clinics and hospitals are quite shocked by these numbers. But because we see so many cases here, we’re trained to always consider ARF. It’s not the easiest illness to diagnose, especially if you’re not familiar with the symptoms and the way they can manifest.

Would you recommend this app to other doctors and clinicians?

Absolutely, ARF presents itself in such a variety of ways and over a period of days and even weeks; having a tool that can collate a range of variables into an accurate diagnosis so quickly and accurately is invaluable, especially when you’re time poor. It’s great for any clinician no matter where they work or how experienced they may be.

For clinicians in major metropolitan areas, where ARF is less frequently seen, it would be easy to overlook or misdiagnose because of the complexities mentioned before. By having the app on your phone, not only does it make diagnosing ARF quick and easy, but seeing it (the app) serves as a reminder to be thinking about ARF.

I’ve also recently heard it’s been updated to enable it to be used more broadly in the Australian setting and expanded to work in any global setting. With something like 15 million people living with RHD around the world^[1], I think this update will be instrumental in trying to eliminate this terrible disease.

Are there any other benefits to using the app?

Definitely, it’s also a great study tool.  When you’re doing your rounds, you can be tested at any minute.  I’d use the app to run through different scenarios and put in a different combination of signs and symptoms just to get as familiar as I could with ARF. And because the app also hasThe Australian guideline for prevention, diagnosis, and management to acute rheumatic fever and rheumatic heart disease (2nd edition) embedded, you have a wealth of information about ARF and RHD at your fingertips.

The ARF diagnosis calculator, initially developed to assist Australian clinicians with this complex diagnosis, was updated in 2016 for use on a global scale. Through an improved algorithm that draws from a wider range of potential diagnosis criteria, the app assists disease awareness and minimises the chances of under-diagnosing the disease.

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1. It is estimated that at least 15.6 million people worldwide are currently living with rheumatic heart disease and another 1.9 million have had rheumatic fever with no rheumatic heart disease. There are approximately 470,000 new cases of rheumatic fever diagnosed and over 230,000 deaths due to rheumatic heart disease each year.