Table 3 Sensitivity, specificity, PPV, NPV, + LR and − LR of evaluated signs in compare to previous studies
From: Jolt accentuation of headache: can this maneuver rule out acute meningitis?
Author | Study population | Micro-organism (frequency) | Sign/maneuver | Sensitivity % | Specifity % | PPV | NPV | LR + | LR − |
|---|---|---|---|---|---|---|---|---|---|
(0.95 CI) | (0.95 CI) | (0.95 CI) | (0.95 CI) | ||||||
Uchihara [9]a | 54 | Viral (28) Bacterial (1) Tuberculosis (1) | Jolt accentuation | 97.1 | 60 | 80.5 | 92.3 | 4.2 | 0.0 |
Thomas et al. [8]b | 297 | Viral (9) Bacterial (3) Fungal (6) | Jolt accentuation | NR | NR | NR | NR | NR | NR |
Nuchal rigidity | 30 | 68 | 26 | 73 | 0.94 | 1.02 | |||
Kernig’s sign | 5 | 95 | 27 | 72 | 0.97 | 1 | |||
Brudzinski sign | 5 | 95 | 27 | 72 | 0.97 | 1 | |||
Aminzadeh et al. [11]a | 14 | Undefined | Jolt accentuation | 100 | 71.5 | 78 | 100 | 1 | 0 |
Nuchal rigidity | 100 | 57 | 70 | 100 | 2.33 | 0 | |||
Waghdhare et al. [6]a | 190 | Viral (62) Bacterial (7) Tuberculosis (30) | Jolt accentuation | 6.06 (2.26–12.7) | 98.9 (94–100) | NR | NR | 5.52 | 0.95 |
Nuchal rigidity | 39.4 (29.7–49.7) | 70.3 (59.8–79.5) | NR | NR | 1.33 | 0.86 | |||
Kernig’s sign | 14.1 (7.95–22.6) | 92.3 (84.8–96.9) | NR | NR | 1.84 | 0.93 | |||
Brudzinski sign | 11.1 (5.68–19) | 93.4 (86.2–97.5) | NR | NR | 1.69 | 0.95 | |||
Tamune et al. [12]c,d | 113 | Viral (38) | Jolt accentuation | 78.9 (66.0–91.9) | 32.0 (21.4–42.6) | NR | NR | 1.16 | 0.66 |
Nakao et al. [7]a | 230 | Viral (1) Bacterial (1) Fungal (1) | Jolt accentuation | 21 | 82 | NR | NR | 1.2 | 1 |
Nuchal rigidity | 13 | 80 | NR | NR | 0.6 | 1.1 | |||
Kernig’s sign | 2 | 97 | NR | NR | 0.8 | 1 | |||
Brudzinski sign | 2 | 98 | NR | NR | 1 | 1 | |||
Sato et al. [13]a,e | 108 | Undefined | Jolt accentuation | 75 (61.8–84.8) | 35.1 (24–48) | NR | NR | 1.16 | 0.71 |
This study | 227 | Bacterial (1) Fungal (1) | Jolt accentuation | 62.5 (49.4–74) | 88.3 (82.1–92.6) | 67.7 (54.2–79) | 85.7 (79.2–90.4) | 5.36 | 0.42 |
Nuchal rigidity | 77.7 (65.2–86.9) | 56.4 (48.4–64.1) | 40.8 (32–50.1) | 86.7 (78.5–92.3) | 1.78 | 0.39 | |||
Kernig’s sign | 50 (37.362.6) | 92.6 (87.2–95.9) | 72.7 (56.9–84.5) | 82.5 (76–87.5) | 6.79 | 0.53 | |||
Brudzinski sign | 64 (51.3–75.3) | 74.2 (66.6–80.6) | 49.3 (38.3–60.5) | 84 (76.7–89.4) | 2.48 | 0.48 |