Novel computerized psychometric tests as primary screening tools for the diagnosis of minimal hepatic encephalopathy

Figure 1 Flow diagram of screening and diagnosing minimal hepatic encephalopathy in high-risk cirrhotic patients. High-risk cirrhotic patients are screened by the inhibitory control test, EncephalApp Stroop App, or critical flicker frequency and are subsequently validated using the psychometric hepatic encephalopathy score (PHES). MHE: Minimal hepatic encephalopathy.

Figure 2 Ideograph of inhibitory control test. A continuous stream of letters is randomly displayed on the computer screen. The subject is instructed to respond if an X is preceded by a Y or a Y is preceded by an X (targets) and is inhibited to respond if an X is followed by an X or a Y followed by a Y (lures).

Figure 3 Ideograph of EncephalApp Stroop App. A, B: The subject is instructed to choose the color corresponding to the color of the presented symbols (“off” runs); C, D: The subject is instructed to choose the color corresponding to the color of the presented words (“on” runs).