title: Normalization of the psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in Turkey.
abstract: To construct normal values for the tests of the psychometric hepatic encephalopathy score (PHES) and evaluate the prevalence of minimal hepatic encephalopathy (MHE) among Turkish patients with liver cirrhosis.
  
  
  
  One hundred and eighty-five healthy subjects and sixty patients with liver cirrhosis without overt hepatic encephalopathy were included in the study. All subjects underwent psychometric tests, which include number connection test-A and B (NCT-A/B), serial dotting test (DST), line drawing test (LDT), and digit symbol test (DST) in the same day. The variables that affected the results of the test were included in the multiple linear regression models and formulas were constructed to predict the expected results for each tests.
  
  
  
  The results of all PHES tests, except the LDT in the cirrhotic group were significantly different than center of gravity (CG) (P < 0,001). The score of PHES in the cirrhotic group was -2,18 ± 3,3 (median -2; range: 11 to +4), significantly lower than CG (-0.31 ± 2.18 [median, 0; range, -8 to +5]) (P < 0.001). the cutoff of PHES was set -4 point. Therefore, 19 of the 60 cirrhotic patients were diagnosed with MHE (31.6%). Among the patients with MHE, 11 (11/45, 24,4%) had Child-Pugh classification (CTP) A and 8 (8/15, 53.3%) had CTP B. No differences in age and education years were found between the MHE and non-MHE groups (P > 0.05).
  
  
  
  Turkish PHES normograms have been developed for detecting patients with MHE. Future multicenter national studies are needed to validate widely applicable norms.
authors.affiliation: Department of Gastroenterology, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors.forename: Bdo
authors.initials: B
authors.lastname: Coskun
authors.affiliation: Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozen
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Gursoy
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Ozbakir
authors.affiliation: Department of Gastroenterology, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors.forename: O K
authors.initials: OK
authors.lastname: Poyrazoglu
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Baskol
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: G C
authors.initials: GC
authors.lastname: Sezgin
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yucesoy
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011237:Predictive Value of Tests; D015995:Prevalence; D011594:Psychometrics / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult