title: A simplified psychometric evaluation for the diagnosis of minimal hepatic encephalopathy.
abstract: OBJECTIVE
  The psychometric hepatic encephalopathy score (PHES), which includes 5 psychometric tests, is a standard for the diagnosis of minimal hepatic encephalopathy (HE). We investigated whether a simplified PHES (SPHES) is as useful as the whole PHES.
  
  
  METHODS
  The PHES was determined for 79 cirrhotic patients (the training group), who were followed up for the development of overt HE. Backward logistic regression was performed by eliminating stepwise variables--removal did not impair regression. A separate series of 65 patients was used as a validation group.
  
  
  RESULTS
  The PHES was abnormal in 45 patients. The SPHES, determined from the digit symbol, serial dotting, and line tracing tests, did not differ significantly from the full PHES; 24 of the 79 patients developed overt HE. The likelihood of developing overt HE was higher among patients with an abnormal PHES (log-rank P = .003) or SPHES (P = .004). By using Cox regression and model for end-stage liver disease scores to analyze data from patients with previous HE and transjugular intrahepatic portosystemic shunts, PHES (relative risk, 4.16; P = .003) and SPHES (relative risk, 3.70; P = .004) were the only variables associated with the development of overt HE. The accuracy of the SPHES was confirmed in the validation group.
  
  
  CONCLUSIONS
  A simplified PHES is as good as the PHES in diagnosing minimal HE and in predicting the occurrence of overt HE.
authors: Department of Clinical Medicine, Center for Diagnosis and Treatment of Portal Hypertension, Sapienza University of Rome, Rome, Italy. oliviero.riggio@uniroma1.it
authors: Oliviero
authors: O
authors: Riggio
authors: Lorenzo
authors: L
authors: Ridola
authors: Chiara
authors: C
authors: Pasquale
authors: Ilaria
authors: I
authors: Pentassuglio
authors: Silvia
authors: S
authors: Nardelli
authors: Federica
authors: F
authors: Moscucci
authors: Manuela
authors: M
authors: Merli
authors: Sara
authors: S
authors: Montagnese
authors: Piero
authors: P
authors: Amodio
authors: Carlo
authors: C
authors: Merkel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000175:diagnosis*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods*