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A Smartphone App to Test for Minimal Hepatic Encephalopathy

Presented: Monday, November 12, 1:45 pm, Liver Meeting®, Hynes Convention Center

BOSTON, Nov. 11, 2012 /PRNewswire/ -- Minimal hepatic encephalopathy (MHE), which is often found in patients with cirrhosis, is difficult to diagnose. This is an important issue because MHE is associated with poor quality of life, progression to severe disease, unemployment, and traffic accidents and can be treated if it is diagnosed. A smartphone app for Stroop task, which is used to evaluate psychomotor speed and cognitive flexibility, could be used to screen for MHE.

Researchers at Virginia Commonwealth University and McGuire Veterans Medical Center attempted to validate the Stroop task app against standard diagnostic tests for MHE. To do so, they studied 125 patients with cirrhosis. Some of those patients did and some (82 of 125) did not have overt hepatic encephalopathy (OHE). Patients with cirrhosis were matched with a control group by age and education. All were tested with both the smartphone app and the psychometric hepatitis encephalopathy battery. A subgroup was tested twice (test-retest group) to assure test-retest reliability.

The outcomes of the test were compared to those of the control group, patients with cirrhosis with OHE, and patients with cirrhosis without OHE. MHE was seen in 44 percent of all patients and 40 percent of those patients who did not have OHE. The app performance was worse in patients with cirrhosis, especially those with OHE and advanced disease, compared to controls.

The test-retest proved the app to be reliable, and a cut-off described was very sensitive for the rapid diagnosis of MHE and cognitive dysfunction. The app could be administered and interpreted within 5 minutes by medical assistants and could play an important role in the rapid and objective screening for this condition in the clinic. According to Dr. Bajaj, "These findings open up a new chapter of point-of-care testing for MHE that can be done in the clinics. We would like to and are in the process of studying the functionality of this app before and after TIPS placement and therapy as well as in patients with concomitant psychoactive medicines."

Dr. Bajaj also noted that, "The results were better than expected when you consider that most of our patients had relatively little exposure to smartphones -- only 30 percent were familiar with smartphones. This shows that the platform for giving the test remains valid despite the initial unfamiliarity of patients. Researchers concluded that the Stroop task smartphone app is a quick, reliable, valid, and inexpensive diagnostic process.

Abstract title: 
The Stroop smartphone app is a short and valid screening tool for minimal hepatitis encephalopathy

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting®, held in Boston, Massachusetts November 9 – 13, will bring together more than 9,000 researchers from 55 countries.

A pressroom will be available from November 10 at the annual meeting. For copies of abstracts and press releases, or to arrange researcher interviews, contact Gregory Bologna at 703-299-9766.

Press releases and all abstracts are available online at

Media Contact: Gregory Bologna
[email protected] 
Press Room: November 10 – 13, 2012
Hynes Convention Center, Boston, MA
Telephone: 617-954-2624

Researcher: Jasmohan Bajaj, MD
Email: [email protected] 
Phone: 804-675-5021 or 804-675-5802

This release was issued through The Xpress Press News Service, merging e-mail and satellite distribution technologies to reach business analysts and media outlets worldwide. For more information, visit


SOURCE American Association for the Study of Liver Diseases (AASLD)

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