SynthesisAlimentary pharmacology & therapeutics2013
Meta-analysis: The diagnostic accuracy of critical flicker frequency in minimal hepatic encephalopathy.
Synthesis in Alimentary pharmacology & therapeutics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Diagnostic accuracy of different ECG-based algorithms in wide QRS complex tachycardia: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications.Clinical and molecular hepatology · 2020Guideline
- At-Home Critical Flicker Frequency Testing in Cirrhosis: A Feasibility Pilot Study Using the Novel Beacon Device.Gastro hep advances · 2026Article
- 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
- Minimal hepatic encephalopathy: Characteristics and comparison of the main diagnostic modalities.Clinical and experimental hepatology · 2024Review
- The Prevalence of Minimal Hepatic Encephalopathy in an Outpatient Hepatology Clinic.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis.Hepatology forum · 2023Article
- Frequency and predictive factors of minimal hepatic encephalopathy before and after sustained virological response in HCV cirrhosis.Clinical and experimental hepatology · 2022Article
- Determination of Turkish norms of psychometric tests for diagnosing minimal hepatic encephalopathy and proposal of a high sensitive screening test battery.Hepatology international · 2021Article
- Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests.Renal failure · 2021Article
- Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis.Journal of personalized medicine · 2021Review
- Critical Flicker Fusion Frequency: A Narrative Review.Medicina (Kaunas, Lithuania) · 2021Review
- Brain-derived neurotrophic factor as a potential diagnostic marker in minimal hepatic encephalopathy.Clinical and experimental hepatology · 2021Article
- Assessment of Alertness and Cognitive Performance of Closed Circuit Rebreather Divers With the Critical Flicker Fusion Frequency Test in Arctic Diving Conditions.Frontiers in physiology · 2021Article
- Minimal hepatic encephalopathy - diagnosis and treatment.Przeglad gastroenterologiczny · 2021Review
- Novel computerized psychometric tests as primary screening tools for the diagnosis of minimal hepatic encephalopathy.World journal of clinical cases · 2020Review
- Neurologic Safety of Etomidate-Based Sedation during Upper Endoscopy in Patients with Liver Cirrhosis Compared with Propofol: A Double-Blind, Randomized Controlled Trial.Journal of clinical medicine · 2020Article
- Advances in psychometric tests for screening minimal hepatic encephalopathy: From paper-and-pencil to computer-aided assessment.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2019Review
- Inert gas narcosis in scuba diving, different gases different reactions.European journal of applied physiology · 2019Observational
- Assessment of Sleep Deprivation and Fatigue Among Chemical Transportation Drivers in Chonburi, Thailand.Safety and health at work · 2018Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMinimal hepatic encephalopathy (MHE) reduces quality of life, increases the risk of road traffic incidents and predicts progression to overt hepatic encephalopathy and death. Current psychometry-based diagnostic methods are effective, but time-consuming and a universal 'gold standard' test has yet to be agreed upon. Critical Flicker Frequency (CFF) is a proposed language-independent diagnostic tool for MHE, but its accuracy has yet to be confirmed.
aimTo assess the diagnostic accuracy of CFF for MHE by performing a systematic review and meta-analysis of all studies, which report on the diagnostic accuracy of this test.
methodsA systematic literature search was performed to locate all publications reporting on the diagnostic accuracy of CFF for MHE. Data were extracted from 2 × 2 tables or calculated from reported accuracy data. Collated data were meta-analysed for sensitivity, specificity, diagnostic odds ratio (DOR) and summary receiver operator curve (sROC) analysis. Prespecified subgroup analysis and meta-regression were also performed.
resultsNine studies with data for 622 patients were included. Summary sensitivity was 61% (95% CI: 55-67), specificity 79% (95% CI: 75-83) and DOR 10.9 (95% CI: 4.2-28.3). A symmetrical sROC gave an area under the receiver operator curve of 0.84 (SE = 0.06). The heterogeneity of the DOR was 74%.
conclusionsCritical Flicker Frequency has a high specificity and moderate sensitivity for diagnosing minimal hepatic encephalopathy. Given the advantages of language independence and being both simple to perform and interpret, we suggest the use of critical flicker frequency as an adjunct (but not replacement) to psychometric testing.
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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.