ArticleHepatology (Baltimore, Md.)2009
Minimal hepatic encephalopathy is associated with motor vehicle crashes: the reality beyond the driving test.
Article in Hepatology (Baltimore, Md.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04330508 (Effects of Direct-acting Antiviral Agents on Cognitive Function, and Depression in Chronic Hepatitis C), which is not on this map. Cited by 123 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Direct-acting Antiviral Agents on Cognitive Function, and Depression in Chronic Hepatitis C
Who cites it
123 citing papers in PubMed, 4 syntheses or guidelines pooled it, 319 citations in OpenAlex.
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Brain Gray Matter Alterations in Hepatic Encephalopathy: A Voxel-Based Meta-Analysis of Whole-Brain Studies.Frontiers in human neuroscience · 2022Pooled it
- Diagnosis of Minimal Hepatic Encephalopathy: A Systematic Review of Point-of-Care Diagnostic Tests.The American journal of gastroenterology · 2018Pooled it
- Meta-analysis: The diagnostic accuracy of critical flicker frequency in minimal hepatic encephalopathy.Alimentary pharmacology & therapeutics · 2013Pooled it
- Trial
- Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy.Gastroenterology · 2011Trial
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Driving in hepatic encephalopathy.Internal medicine journal · 2026Review
- A Proof-of-Concept Study of Language-Stratified Assessment for Minimal Hepatic Encephalopathy: Integrating the Animal Naming Test and Serum IL-6.The Kaohsiung journal of medical sciences · 2026Article
- Minimal Hepatic Encephalopathy: A Narrative Review.Cureus · 2026Review
- Extracellular vesicles from plasma of patients with minimal hepatic encephalopathy induce neuroinflammation and cognitive impairment in rats, which are prevented by treating the patients with rifaximin.Journal of neuroinflammation · 2026Article
- The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.Hepatology communications · 2026Article
- Advances in understanding, diagnosing, and treating hepatic encephalopathy: from epidemiology to emerging therapies.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- At-Home Critical Flicker Frequency Testing in Cirrhosis: A Feasibility Pilot Study Using the Novel Beacon Device.Gastro hep advances · 2026Article
- Oculometric Assessment of Sensorimotor Impairment Associated with Liver Disease Is as Sensitive as Standard of Care Cognitive Tests.Geriatrics (Basel, Switzerland) · 2025Article
- Cortical microstructural changes in minimal hepatic encephalopathy: a gray matter-based spatial statistics study.Quantitative imaging in medicine and surgery · 2025Article
- Deploying and Examining Beacon for At-Home Patient Self-Monitoring with Critical Flicker Frequency.Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference · 2025Article
- QuickStroop for screening for minimal hepatic encephalopathy in patients with cirrhosis.JHEP reports : innovation in hepatology · 2025Article
- TIPS and hepatic encephalopathy in patients with cirrhosis.Metabolic brain disease · 2025Review
- Alteration of dynamical degree centrality in brain functional network and its association with metabolic disorder in minimal hepatic encephalopathy.Neuroradiology · 2025Article
63 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
unlabelledPatients with minimal hepatic encephalopathy (MHE) have impaired driving skills, but association of MHE with motor vehicle crashes is unclear. Standard psychometric tests (SPT) or inhibitory control test (ICT) can be used to diagnose MHE. The aim was to determine the association of MHE with crashes and traffic violations over the preceding year and on 1-year follow-up. Patients with cirrhosis were diagnosed with MHE by ICT (MHEICT) and SPT (MHESPT). Self and department-of-transportation (DOT)-reports were used to determine crashes and violations over the preceding year. Agreement between self and DOT-reports was analyzed. Patients then underwent 1-year follow-up for crash/violation occurrence. Crashes in those with/without MHEICT and MHESPT were compared. 167 patients with cirrhosis had DOT-reports, of which 120 also had self-reports. A significantly higher proportion of MHEICT patients with cirrhosis experienced crashes in the preceding year compared to those without MHE by self-report (17% vs 0.0%, P = 0.0004) and DOT-reports (17% vs 3%, P = 0.004, relative risk: 5.77). SPT did not differentiate between those with/without crashes. A significantly higher proportion of patients with crashes had MHEICT compared to MHESPT, both self-reported (100% vs 50%, P = 0.03) and DOT-reported (89% vs 44%, P = 0.01). There was excellent agreement between self and DOT-reports for crashes and violations (Kappa 0.90 and 0.80). 109 patients were followed prospectively. MHEICT patients had a significantly higher future crashes/violations compared to those without (22% vs 7%, P = 0.03) but MHESPT did not. MHEICT (Odds ratio: 4.51) and prior year crash/violation (Odds ratio: 2.96) were significantly associated with future crash/violation occurrence.
conclusionPatients with cirrhosis and MHEICT have a significantly higher crash rate over the preceding year and on prospective follow-up compared to patients without MHE. ICT, but not SPT performance is significantly associated with prior and future crashes and violations. There was an excellent agreement between self- and DOT-reports.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.