ArticleHepatology international2021
Determination of Turkish norms of psychometric tests for diagnosing minimal hepatic encephalopathy and proposal of a high sensitive screening test battery.
Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Psychometric hepatic encephalopathy score (PHES) - when, how, why, and why not: a guide for the unfamiliar.Przeglad gastroenterologiczny · 2025Review
- 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
- Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions.World journal of gastroenterology · 2022Review
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Authors and funding
16 authors.
Funding
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Abstract
backgroundPsychometric hepatic encephalopathy score (PHES) needs local standardization.
aimsThis study aimed at standardizing PHES for Turkish patients and compare them with German norms; to determine minimal hepatic encephalopathy (mHE) prevalence with two different methods [PHES battery and Critical Flicker Frequency (CFF)] and to assess whether sub-tests of the battery can be used for screening for mHE.
methodsHealthy volunteers (n = 816; 400 male) and cirrhotics (n = 124; 58 male) were included. For mHE diagnosis PHES score threshold was set at ≤ - 5 points and that of CFF at < 39 Hz. For comparing German and Turkish norms, datasets were combined. Multiple backward procedure was applied to assess effects of age, sex and education on single tests of the battery. Receiver operating characteristic (ROC) curves were created for assessing diagnostic capabilities of subtests of the battery.
resultsPHES norms for Turks were developed. MHE prevalence in compensated cirrhotics was 29.8% and 27.4% with PHES and CFF tests, respectively, with low compatibility (kappa coefficient 0.389); mHE prevalence decreased to 16% when both tests were combined. Turks performed worse vs Germans in the digit symbol (DS) and serial dotting (SD) subtests but performed better in other subtests. In ROC analyzes of subtests, the combination of DS + SD tests achieved an AUROC of 0.974 versus PHES.
conclusionsUse of two methods for diagnosing mHE is important for research purposes. From a clinical perspective, sensitivity with acceptable specificity may suffice for screening instruments for mHE. Combined use of DS and SD subtests of the PHES battery appears suitable for this purpose.
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