Sensitivity and Specificity of Jolt Accentuation Maneuver in Diagnosis of Acute Meningitis
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Abstract
Background: Acute meningitis is a potentially fatal illness that necessitates immediate identification and medical intervention. The Jolt Accentuation Maneuver (JAM) is a straightforward and non-invasive diagnostic test that can help in diagnosis of acute meningitis.
Objectives: This study assessed the accuracy of JAM in detecting acute meningitis by evaluating its sensitivity and specificity.
Methods: The study was done at Pak Emirate Military Hospital, Rawalpindi, from January 2024 to June 2024, using prospective observational method. 280 patients with symptoms indicative of meningitis were included in the study. Every patient received JAM procedure, followed by an examination of CSF, which was used as the definitive method for diagnosis.
Results: The study group had average age of 35.2 years and was almost equally divided between males (50.7%) and females (49.3%). The prevalent symptoms consisted of headache (97.1%), fever (92.9%) and neck stiffness (82.1%). The JAM test demonstrated sensitivity of 88.9% (p<0.001) and specificity of 60.0% (p<0.05). The positive predictive value (PPV) was 80.0% (p<0.05) and negative predictive value (NPV) was 75.0% (p<0.05). The overall accuracy of the data was 82.1% (p<0.001) indicating statistical significance. The study of ROC curve revealed an area under the curve of 0.90, indicating a high level of diagnostic accuracy.
Conclusions: JAM is a diagnostic test for acute meningitis that is quite sensitive and has a decent level of specificity. Due to its high sensitivity, it is highly effective tool for initial screening, particularly in emergency circumstances. Nevertheless, because of its moderate specificity, it is necessary to confirm positive JAM results with other diagnostic testing. Incorporating JAM into clinical practice can expedite diagnosis and prompt treatment, potentially enhancing patient outcomes.
Keywords: Acute meningitis, Diagnosis, Jolt Accentuation Maneuver, Sensitivity, Specificity.
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