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RESEARCH PRODUCT

Validation of the simplified Animal Naming Test as primary screening tool for the diagnosis of covert hepatic encephalopathy

Jens U. MarquardtM Nguyen-tatTim ZimmermannMartin F. SprinzlPeter R. GalleYvonne HuberChristian LabenzGerrit ToengesMichael NagelMarcus-alexander WörnsJörn M. SchattenbergLarissa Beul

subject

Liver CirrhosisMalePediatricsmedicine.medical_specialtyPsychometricsFlicker fusion thresholdNeuropsychological Tests030204 cardiovascular system & hematologyRisk AssessmentSeverity of Illness Index03 medical and health sciences0302 clinical medicineReference ValuesGermanyInternal MedicinemedicineAnimalsHumansIn patientProspective Studies030212 general & internal medicineHepatic encephalopathyAgedbusiness.industryMiddle Agedmedicine.diseaseTest (assessment)Clinical PracticeROC CurveCovertCase-Control StudiesHepatic EncephalopathyCohortFemalebusinessPrimary screening

description

Diagnosis of covert hepatic encephalopathy (CHE) is time consuming in clinical practice. Recently, a new diagnostic tool - the simplified Animal Naming Test (S-ANT1) - was presented with promising results in an Italian cohort. The aim of the present study was to validate S-ANT1 in a cohort of cirrhotic patients from a German tertiary referral centre.143 cirrhotic patients and 37 healthy controls were enrolled. Hepatic encephalopathy (HE) grade 1 (HE1) was clinically diagnosed according to the West-Haven Criteria. Critical flicker frequency and Psychometric Hepatic Encephalopathy Score were used to detect minimal HE (MHE). All participants were additionally examined by S-ANT1.58 (40.6%) patients presented with CHE (40 MHE, 18 HE1). S-ANT1 was lowest in patients with HE1, followed by patients with MHE, patients without CHE, and healthy controls, respectively (each p  0.05). Naming20 animals discriminated best between patients with and without CHE in ROC analysis (with Youden's index). With a cut-off value of ≥23 mentioned animal names further testing for CHE could be avoided in 38.5% of patients with a negative predictive value of 84%.S-ANT1 may become an important first screening tool for the assessment of CHE in clinical practice.

https://doi.org/10.1016/j.ejim.2018.08.008