A5V4d

Feverish illness in children
Table 5.28 GRADE profile for evaluation of neck stiffness
Number
of
studies
80
Number
of
children
Nuchal rigidity
Sensitivity
(95%
confidence
interval)
For detecting bacterial meningitis
1
(Ghotbi,
2009)
1
(Offringa
, 1992)
Specificity
(95%
confidence
interval)
254 8 (0 to 24) a 100 (100 to
100) a
92 48 (27 to
68) a
For detecting meningococcal disease
1
(Nielsen,
2001)
208 41 (26 to
56) a
100 (100 to
100) a
97 (94 to
100) a
Positive
predictive
value
(95%
confidence
interval)
100 (100 to
100) a
100 (100 to
100) a
76 (58 to
94) a
Negative
predictive
value
(95%
confidence
interval)
96 (93 to
98) a
85 (77 to
93) a
88 (83 to
92) a
Positive
likelihood
ratio
(95%
confidence
interval)
Negative
likelihood
ratio
(95%
confidence
interval)
NC 0.9 (0.8 to
1.1) a
NC 0.5 (0.4 to
0.8) a
13.9 (5.4 to
35.6) a
NC Not calculable
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study
Table 5.29 GRADE profile for evaluation of focal seizures
Number
of
studies
Number
of
children
Focal seizures
Sensitivity
(95%
confidenc
e interval)
For detecting bacterial meningitis
1
(Akpede,
1992)
1 (Joffe,
1983)
522 41 (20 to
61) a
241 38 (12 to
65) b
Specificity
(95%
confidence
interval)
92 (90 to 94)
a
91 (87 to 95)
b
Positive
predictive
value
(95%
confidence
interval)
18 (8 to 29)
a
20 (4 to 34)
b
Negative
predictive
value
(95%
confidence
interval)
97 (96 to
99) a
96 (94 to
99) b
Positive
likelihood
ratio
(95%
confidence
interval)
5.1 (2.9 to
9.2) a
4.2 (1.9 to
9.3) a
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study.
b Confidence intervals were calculated by the NCC-WCH based on results reported in the study.
0.6 (0.5 to
0.8) a
Negative
likelihood
ratio
(95%
confidence
interval)
0.6 (0.5 to
0.9) a
0.7 (0.4 to
1.0) a
Quality
Low
Very
low
Very
low
Quality
Very
low
Very
low