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. 2019 Apr 8;30(5):398–407. doi: 10.5152/tjg.2019.18226

Table 1.

Diagnostic and screening methods of MHE

Tests Tested domains Time required (min) Influence factor Advantages Disadvantages
Paper-and-pencil test PHES Psychomotor speed, visual perception, visuospatial orientation, visuomotor ability, and attention 20 Age, education, and culture Gold standard for MHE diagnosis validated internationally Learning effects
RBANS Psychomotor speed, anterograde memory, and working memory 30 Age, education, and culture Rigorous population-based standardization values Required further validation in randomized controlled trials
Computer-aided test Scan test Working memory, vigilance, and attention 15 Age and education Simple administration Learning effects
CDR assessment battery Reaction time, memory, and recognition 15 Age, education, and culture Appreciable test-retest reliability Learning effects
ICT Response inhibition, working memory, vigilance, and attention 15 Age, education, and culture Simple administration, higher sensitivity/specificity, and appreciable test-retest reliability Not suitable for non-English-speaking patients
EncephalApp Stroop App Psychomotor speed and cognitive alertness 10 Age, education, and culture Rapid and simple administration, and good test-retest reliability Should be familiar with iPhone/iPad
CFF Visual discrimination and general arousal 10 Age Simple and easily performed and no learning effects Not suitable for red-green blindness and visual impairment

PHES: psychometric hepatic encephalopathy score; RBANS: repeatable battery for the assessment of neuropsychological status; CDR: Cognitive Drug Research; ICT: inhibitory control test; CFF: critical flicker frequency; MHE: minimal hepatic encephalopathy