Smartphone app can pick up covert hepatic encephalopathy

Researchers have road-tested an app based on the Stroop test, which is designed to detect covert hepatic encephalopathy, with results suggesting it achieves results similar to those of a paper-based Stroop test.

The smartphone-based EncephalApp was tested in 167 patients with cirrhosis and 114 healthy age-matched controls, and showed significant correlation with individual paper/pen test and with crashes and illegal turns in driving simulation tests, as well as high test/retest reliability at 1 and 3 months.

The study also found that patients with prior overt hepatic encephalopathy had significantly worse response times with the EncephalApp compared to controls (Clin Gastroenterol Hepatol. 2015;13:1828-35).

“Although these [gold standard paper-pencil] measures are used to diagnose CHE [covert hepatic encephalopathy] in research studies, they have not found traction in clinical practice because of their copyrighted nature, need for psychological expertise, and time requirements,” wrote Dr. Jasmohan S. Bajaj of Virginia Commonwealth University and McGuire VA Hospital, both in Richmond, Va.

“Our results are in sync with the prior experience with the old Stroop App in that in similar prior HE [hepatic encephalopathy] studies, we found that the psychomotor function, i.e., the time required to complete tasks, was much more predictive than the errors committed (number of runs required) and the cognitive flexibility measures (OnTime-OffTime) in differentiating groups,” wrote Dr. Bajaj and colleagues.

The National Institute of Diabetes and Digestive and Kidney Diseases, the National Center for Advancing Translational Research and the McGuire Research Institute funded the study. There were no other conflicts of interest declared.

Researchers have road-tested an app based on the Stroop test, which is designed to detect covert hepatic encephalopathy, with results suggesting it achieves results similar to those of a paper-based Stroop test.

The smartphone-based EncephalApp was tested in 167 patients with cirrhosis and 114 healthy age-matched controls, and showed significant correlation with individual paper/pen test and with crashes and illegal turns in driving simulation tests, as well as high test/retest reliability at 1 and 3 months.

The study also found that patients with prior overt hepatic encephalopathy had significantly worse response times with the EncephalApp compared to controls (Clin Gastroenterol Hepatol. 2015;13:1828-35).

“Although these [gold standard paper-pencil] measures are used to diagnose CHE [covert hepatic encephalopathy] in research studies, they have not found traction in clinical practice because of their copyrighted nature, need for psychological expertise, and time requirements,” wrote Dr. Jasmohan S. Bajaj of Virginia Commonwealth University and McGuire VA Hospital, both in Richmond, Va.

“Our results are in sync with the prior experience with the old Stroop App in that in similar prior HE [hepatic encephalopathy] studies, we found that the psychomotor function, i.e., the time required to complete tasks, was much more predictive than the errors committed (number of runs required) and the cognitive flexibility measures (OnTime-OffTime) in differentiating groups,” wrote Dr. Bajaj and colleagues.

The National Institute of Diabetes and Digestive and Kidney Diseases, the National Center for Advancing Translational Research and the McGuire Research Institute funded the study. There were no other conflicts of interest declared.

Researchers have road-tested an app based on the Stroop test, which is designed to detect covert hepatic encephalopathy, with results suggesting it achieves results similar to those of a paper-based Stroop test.

The smartphone-based EncephalApp was tested in 167 patients with cirrhosis and 114 healthy age-matched controls, and showed significant correlation with individual paper/pen test and with crashes and illegal turns in driving simulation tests, as well as high test/retest reliability at 1 and 3 months.

The study also found that patients with prior overt hepatic encephalopathy had significantly worse response times with the EncephalApp compared to controls (Clin Gastroenterol Hepatol. 2015;13:1828-35).

“Although these [gold standard paper-pencil] measures are used to diagnose CHE [covert hepatic encephalopathy] in research studies, they have not found traction in clinical practice because of their copyrighted nature, need for psychological expertise, and time requirements,” wrote Dr. Jasmohan S. Bajaj of Virginia Commonwealth University and McGuire VA Hospital, both in Richmond, Va.

“Our results are in sync with the prior experience with the old Stroop App in that in similar prior HE [hepatic encephalopathy] studies, we found that the psychomotor function, i.e., the time required to complete tasks, was much more predictive than the errors committed (number of runs required) and the cognitive flexibility measures (OnTime-OffTime) in differentiating groups,” wrote Dr. Bajaj and colleagues.

The National Institute of Diabetes and Digestive and Kidney Diseases, the National Center for Advancing Translational Research and the McGuire Research Institute funded the study. There were no other conflicts of interest declared.