ArticleJournal of gastroenterology2022
A shortened Stroop test to identify covert hepatic encephalopathy and predict overt hepatic encephalopathy in patients with cirrhosis.
Article in Journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Development of overt hepatic encephalopathy increases mortality in patients with cirrhosis: a multicenter retrospective cohort study.Journal of gastroenterology · 2026Article
- Higher Education Influences Stroop Performance in Non-Demented Older Adults: The Mediating Role of Resting-State Brain Activity.Clinical and translational science · 2025Article
- Current management and future perspectives of covert hepatic encephalopathy in Japan: a nationwide survey.Journal of gastroenterology · 2025Article
- QuickStroop for screening for minimal hepatic encephalopathy in patients with cirrhosis.JHEP reports : innovation in hepatology · 2025Article
- Serum zinc levels as predictors of covert hepatic encephalopathy in patients with liver cirrhosis.Journal of gastroenterology · 2025Observational
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCovert hepatic encephalopathy (CHE) adversely affects the clinical outcomes of patients with cirrhosis but remains largely undiagnosed and untreated. Although the Stroop test is a useful method for CHE detection, a faster, simpler, and more accurate test is required to diagnose CHE. This prospective study aimed to develop a new shortened Stroop test that can detect CHE and predict overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis.
methodsPatients who underwent neuropsychological tests (NPT) and the Stroop test between November 2018 and December 2021 were enrolled and followed until OHE occurrence or March 2022. The discriminative ability of various run combinations in the off and on states to detect CHE was evaluated using the area under the receiver-operating characteristic curve (AUC) and compared with that of the total Stroop test time.
resultsAmong the 227 eligible patients, the On1-2Time cutoff value of 44.4 s had a comparable discriminative ability with the total Stroop test time to detect CHE, with an AUC of 0.791, a sensitivity of 0.827, and a specificity of 0.685. During a median follow-up period of 16 months, 37 patients developed OHE. On1-2Time ≥ 44.4 s (hazard ratio [HR], 3.93; 95% confidence interval [CI] 1.36-11.36) and serum albumin levels (HR, 0.28; 95% CI 0.11-0.67) were independently associated with OHE occurrence.
conclusionsThe shortened Stroop test (On1-2Time) is equivalent to the total Stroop test not only for identifying CHE but also for estimating the risk of progression to OHE.
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