Evidence map›Paper›PMID 40170910›Full record

ArticleJHEP reports : innovation in hepatology2025

QuickStroop for screening for minimal hepatic encephalopathy in patients with cirrhosis.

Christian Labenz, Simon J Gairing, Leonard Kaps, Alena F Ehrenbauer, Eva M Schleicher, Sophie Mengel, Julius F M Egge, Maria M Gabriel, Peter R Galle, Heiner Wedemeyer and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Christian LabenzDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Simon J GairingDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Leonard KapsDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Alena F EhrenbauerDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Eva M SchleicherDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Sophie MengelDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Julius F M EggeDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Maria M GabrielDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Peter R GalleDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Heiner WedemeyerDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Alexander ZipprichFirst Department of Internal Medicine, Martin-Luther University Halle-Wittenberg, Halle, Germany.
Cristina RipollFirst Department of Internal Medicine, Martin-Luther University Halle-Wittenberg, Halle, Germany.
Robin GreinertFirst Department of Internal Medicine, Martin-Luther University Halle-Wittenberg, Halle, Germany.
Benjamin MaasoumyDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background & Aims: QuickStroop, a shortened version of the Stroop EncephalApp, has recently been proposed for screening for minimal hepatic encephalopathy (MHE) in patients with cirrhosis in the USA. At present, there are no data on its clinical utility for MHE screening in patients in Europe, and only limited data are available regarding its comparison to the Animal Naming Test (ANT). Methods: In total, 242 patients with cirrhosis without signs of hepatic encephalopathy (HE) ≥ grade 1 and no history of overt HE were included as the development cohort. Another independent cohort comprising 104 patients with cirrhosis from a different center served as a validation set. MHE was defined using the psychometric hepatic encephalopathy score (PHES) (PHES-MHE). All patients were tested with the complete EncephalApp Stroop. A subset was also tested with the ANT. Regression formulas were fitted for patients above and below the age of 60 years, including the first two off-state runs, age, and school education (QuickStroop). Results: PHES-MHE was detected in 76 (31%) patients. The first two off-state runs of the EncephalApp demonstrated a comparable discriminative ability to the complete Stroop test in distinguishing between patients with and without PHES-MHE. QuickStroop had a better discriminative ability in patients below than above the age of 60 years. The discriminative ability of QuickStroop (total cohort: AUC 0.88) was superior to ANT (AUC 0.70). QuickStroop predicted PHES-MHE with a sensitivity of 74% and a specificity of 89%, and took a median of only 34.5 s to complete. The acceptable discriminative ability of QuickStroop was confirmed in the validation cohort (AUC 0.81). Conclusion: QuickStroop is a rapid screening tool to identify patients at risk for PHES-MHE, especially in patients below 60 years of age. Impact and implications: QuickStroop, a shortened version of the Stroop EncephalApp, has recently been proposed for screening for MHE in patients with cirrhosis in the USA. In this study, we validated QuickStroop for patients in Germany with cirrhosis and demonstrate a good diagnostic accuracy for detecting MHE, especially in patients below 60 years of age. Additionally, QuickStroop might be superior to the ANT in patients below 60 years of age. The use of QuickStroop in clinical practice could facilitate screening for MHE.

Indexed as

Cognitive dysfunctionHepatic encephalopathyPsychometric hepatic encephalopathy scoreStroop EncephalApp

Identifiers

PMID40170910
PMCPMC11959648

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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.