Original articlePancreas, biliary tract, and liverCombined Scores from the EncephalApp Stroop Test, Number Connection Test B, and Serial Dotting Test Accurately Identify Patients With Covert Hepatic Encephalopathy
Section snippets
Study Population
Healthy subjects were enrolled in an epidemiological survey study from 9 communities in Shanghai, China. The inclusion criteria were healthy volunteers above 18 years of age. The exclusion criteria were similar to our previous study.9 Those subjects who had an alcohol intake of more than 30 g/d in men or 20 g/d in women were excluded as well.
To determine the new strategy for CHE diagnosis, the data reported in our previous study were reanalyzed to develop a 2-step method by means of a
Range of Scores for the EncephalApp Stroop Test in the General Population
In total, 569 volunteers were enrolled to determine the range of scores of the EncephalApp Stroop test in the general population, including 229 (40.2%) men and 340 (59.8%) women, from 18 to 67 years of age, with education levels ranging from 2 to 23 years (Supplementary Table 1). As shown in Supplementary Figure 1, the average OnTime was significantly longer than OffTime (82 ± 21 seconds vs 73 ± 19 seconds; P < .001), and the number of On runs was obviously higher than the number of Off runs
Discussion
Although a series of psychometric and neurophysiological tests reflecting the subtle neuropsychological impairments in cognitive function, attention, psychomotor speed, and information processing speed have been applied in the diagnosis of CHE,2 the proportion of cirrhotic patients who underwent routine tests for CHE remains very low in practice. Our present study collected the range of EncephalApp Stroop test scores in China and established a novel strategy for CHE diagnosis with high
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QuickStroop, a Shortened Version of EncephalApp, Detects Covert Hepatic Encephalopathy With Similar Accuracy Within One Minute
2023, Clinical Gastroenterology and HepatologyCitation Excerpt :The data generated here could potentially streamline the diagnosis of CHE using EncephalApp in clinics where the time burden would go down substantially, make it possible to administer while checking in patients, and recording data on smart devices to present to clinicians seeing the patients later in the clinic. The PHES is considered the gold standard but the translation into clinic has been fraught with issues related to norm development and need for a long period of time for administration and scoring.1,9 There have been attempts to shorten this time in clinical studies,10 but there remains a gap in clinical application.
EncephalApp Stroop Test validation for the screening of minimal hepatic encephalopathy in Brazil
2022, Annals of HepatologyCitation Excerpt :Testing with PHES or EncApp_ST alone, or a PHES plus EncApp_ST combination, is equivalent to diagnosing covert HE and predicting overt HE development [20]. In contrast, a multicenter Chinese survey showed that combined scores from the EncApp_ST, NCT-B, and SDT identified patients with covert HE with approximately 87% accuracy, and in a much shorter time than the standard PHES [21]. In our study, the PHES was performed as a gold standard method to select patients with MHE.
Covert hepatic encephalopathy is associated with aggressive disease progression and poor survival in patients with cirrhosis
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2023, Seminars in Interventional RadiologyChinese Consensus on Clinical Diagnosis and Therapy of Liver Cirrhosis
2023, Chinese Journal of GastroenterologyPrevalence and risk factors of covert hepatic encephalopathy in cirrhotic patients: A multicenter study in China
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Conflicts of interest The authors have no conflicts to disclose.
Funding This work was supported by the Top-Level Clinical Discipline Project of Shanghai Pudong (PWYgf2018-04), the Science and Technology Guidance Plan of Shanghai Science and Technology Commission (19411970500), the Emerging Advanced Technology Joint Research Project of Shanghai Hospital Development Center (SHDC12016103), and the Shanghai Natural Science Fund (16ZR1436400).
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Authors share co-first authorship.