Details

Autor(en) / Beteiligte

• Neye, R.M.
• Kircheis, G.
• Hilger, N.
• Lüth, S.

Titel

P: 8 Assessment of Cirrhotic Patients With Covert Hepatic Encephalopathy (HE) Through the EncephalApp (Stroop-Test) Based on Critical Flicker Frequency and PHES-Test

Ist Teil von

• The American journal of gastroenterology, 2019-09, Vol.114 (1), p.S4-S4

Erscheinungsjahr

2019

Beschreibungen/Notizen

• BACKGROUND: In daily clinical practice, the detection of HE is still less represented but strongly required. Therefore, we assessed the EncephalApp (Stroop-Test) in a German population by standard diagnostic procedures such as the Critical Flicker Frequency (CFF) and the PHES-Test (Psychometric Hepatic Encephalopathy Score). One of the purposes of the trial was finding a Cut-Off value for the EncephalApp in the German population. METHODS: 81 patients with liver cirrhosis underwent the testing of the CFF, the PHES-Test and the EncephalApp. A control group of 25 healthy subjects were examined in the same manner. The CFF was considered pathological with <39 Hz and the PHES-Test with < - 4 value points. The On-plus-Off Time of the EncephalApp was compared to the results of the CFF and the PHES-Test. Different Cut-Offs of the On-plus-Off Time were analyzed. Within these HE groups, the mean values of the PHES-Test, the CFF and the On-plus-Off Time of the EncephalApp were compared and the ROC Analysis (receiver operating characteristic) was conducted. Laboratory parameters, clinical data, and further imaging techniques were also included and compared. RESULTS: The study group (n = 81) included 52 men and 29 women (62.8 years ± 12.5). For the evaluation of the EncephalApp, different Cut-Off values were determined and their specificity and sensitivity were calculated. The comparative parameter was the result of the PHES-Test. Through the creation of a ROC curve, the AUC (area under the curve) showed that the Cut-Off time of >224 sec with 0.803 is the most efficient with better sensitivity (79%) and specificity (82%). Other Cut-Off values showed lower sensitivities and higher false negative values. CONCLUSIONS: After evaluating the specificity, sensitivity and AUC the most efficient Cut-Off value for the On-plus-Off Time in the EncephalApp is >224 sec. In comparison with the CFF and the PHES testing, most of the patient withdrawals (especially in higher grade HE) within the study were registered by the EncephalApp. The EncephalApp is a valid and quick method to diagnose minimal HE but has its limitations in the grading between HE grade 1 and 2.