Determination of Turkish Norms of Psychometric Tests For Diagnosing Minimal Hepatic Encephalopathy and Proposal of a Simplified Paper Pencil Test Battery
Diğer yayınlar > Diğer · 2021
Yazarlar: Burak Özbaş, Onur Keskin, Hartmut Hecker, İrfan Karahan, Cansu Özbaş, Çağdaş Kalkan, Aysun Kartal, Fatih Oğuz Önder, Burcu Kahveci Öncü, Genco Gençdal, Murat Akyildiz, Fulya GÜNŞAR, Ramazan Idilman, Karin Weissenborn, Ömer Özütemiz, Cihan Yurdaydin
Diğer, Uluslararası, 2021,
Özet
Abstract Background: Psychometric hepatic encephalopathy score (PHES) needs standardization for countries and is used for minimal hepatic encephalopathy (mHE) diagnosis. Assessing it is cumbersome.Aims: To standardize PHES for Turkish patients and compare it with German norms; to determine mHE prevalence with two different methods and to assess whether the PHES test can be simplified.Methods: Healthy volunteers (n=816; 400 male) and cirrhotics (n=124; 58 male) were included. PHES score threshold was set at ≤-5 points and that of critical flicker frequency (CFF) at <39 Hz for mHE diagnosis. For comparing German and Turkish norms, datasets were combined. Multiple backward procedure was applied. Receiver operating characteristic (ROC) curves were created for assessing diagnostic capabilities of single subtests of the PHES test. Results: Turkish norms displayed non-linear dependence on age and education. Rate of mHE in compensated cirrhotics was 29.8% and 27.4% with PHES and CFF tests, respectively. Compatibility of two tests was low (kappa coefficient 0.389); mHE prevalence decreased to 16% when both tests were combined. Turks performed worse vs Germans in the digit symbol (DS) and serial dotting (SD) subtests but generally performed better in the other subtests. In ROC analyzes of subtests, AUROC was 0.974 for DS+SD tests combined. Conclusions: PHES norms for Turks were developed. Use of 2 methods for diagnosing mHE may be important for research purposes. From a clinical perspective sensitivity with acceptable specificity may suffice. Combined use of DS and SD subtests of the PHES battery may well be suited for use in clinical practice.