ENCEPHALAPP STROOP TO DETECT COVERT HEPATIC ENCEPHALOPATHY IN PATIENTS WITH COMPENSATED CIRRHOSIS

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.102026

Oscar Suazo , Kemo Sayon , Yusimik Román , Sila M. Gonzales , Mirtha Infante Velasquez , Marlén Castellanos , Danay Guerrero , Susana Borges

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引用次数: 0

Abstract

Introduction and Objectives

Covert hepatic encephalopathy (CHE) is a common complication in patients with compensated cirrhosis, associated with subtle cognitive impairment and a worse prognosis. The EncephalApp Stroop is a digital tool that facilitates its identification.

To evaluate the diagnostic capacity of the EncephalApp Stroop to identify CHE in patients with compensated cirrhosis

Materials and Methods

A diagnostic evaluation study was conducted in patients with compensated cirrhosis treated at the Institute of Gastroenterology in Havana, Cuba, between March 2023 and December 2024. All participants completed the EncephalApp Stroop and the Psychometric Hepatic Encephalopathy Score (PHES). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. The discriminatory capacity of the test was assessed using ROC curve analysis, considering a cutoff point of >190 seconds in the “on” time metric plus “off” time, and the PHES result as the gold standard.

Results

Seventy patients of both sexes were included, with a predominance of viral etiology (74.3%). The prevalence of EHE was 38.6%. The EncephalApp Stroop showed a sensitivity of 95.2% (95% CI: 77.3% to 99.2%) and specificity of 85.7% (95% CI: 73.3% to 92.9%), PPV of 74.1% (95% CI: 55.3% to 86.8%) and NPV of 97.7% (95% CI: 87.9% to 99.6%) for the detection of HSE, with an area under the ROC curve of 0.905 (95% CI: 0.826-0.984).

Conclusions

The EncephalApp Stroop is a valid, accessible, and efficient diagnostic test for identifying EHE in compensated cirrhosis, with high performance compared to PHES as the gold standard. Its implementation can optimize early detection and clinical management.

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脑电图检测代偿性肝硬化患者隐匿性肝性脑病

隐蔽性肝性脑病（CHE）是代偿性肝硬化患者的常见并发症，伴有细微的认知障碍和较差的预后。EncephalApp Stroop是一种便于识别的数字工具。为了评估EncephalApp Stroop在代偿性肝硬化患者中识别CHE的诊断能力材料和方法，研究人员于2023年3月至2024年12月在古巴哈瓦那胃肠病学研究所对代偿性肝硬化患者进行了一项诊断评估研究。所有参与者都完成了EncephalApp Stroop和肝性脑病心理测量评分（PHES）。测定敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。采用ROC曲线分析，考虑“开”时间指标加“关”时间的截断点为190秒，以PHES结果为金标准，评估试验的鉴别能力。结果共纳入70例患者，男女均有，以病毒性病因为主（74.3%）。EHE患病率为38.6%。EncephalApp Stroop检测HSE的灵敏度为95.2% (95% CI: 77.3% ~ 99.2%)，特异性为85.7% (95% CI: 73.3% ~ 92.9%)， PPV为74.1% (95% CI: 55.3% ~ 86.8%)， NPV为97.7% (95% CI: 87.9% ~ 99.6%)， ROC曲线下面积为0.905 （95% CI: 0.826 ~ 0.984）。结论EncephalApp Stroop是代偿性肝硬化EHE诊断的一种有效、便捷、高效的检测方法，与PHES相比具有较高的性能。它的实施可以优化早期发现和临床管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.