Limits...
The mind and liver test: a new approach to the diagnosis of minimal hepatic encephalopathy in resource-poor settings.

Das S, Ali SM, Seward J, Venkataraman J - Int J Hepatol (2014)

Bottom Line: Results.Test-retest agreement was high (ICC = 0.89).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Gastroenterology, Stanley Medical College and Hospital, Chennai 600001, India.

ABSTRACT
Background and Aims. Minimal hepatic encephalopathy (MHE) is diagnosed using neuropsychometric tests or neurophysiological tests that are either inapplicable to illiterate patient population in resource-poor settings or require sophisticated and expensive equipment. The available tests assess discrete domains of mental impairment. Our aim was (a) to design a neuropsychometric test that measures all domains of mental impairment in MHE using one metric; (b) to evaluate its sensitivity, specificity, and reproducibility. Methods. The mind and liver test (MALT), a psychometric test assessing cognition, memory, and psychometric impairment, each on a scale of 20, was designed keeping in mind the requirements of a universal test. 40 cirrhotics and 36 controls were subjected to critical flicker frequency (CFF) and MALT in same sitting. ROC curve was plotted for MALT using CFF as gold standard. Bland-Altman plot was used to find test-retest agreement. Results. CFF values and MALT scores varied significantly between the cases and the controls (P < 0.05). MALT was 94% sensitive and 83% specific. Using ROC with CFF as gold standard, the AUC for diagnosis of MHE using MALT score was 0.89. Test-retest agreement was high (ICC = 0.89). Conclusion. In this pilot study, MALT proved to be highly sensitive, specific, inexpensive, and reproducible.

No MeSH data available.


Related in: MedlinePlus

Study design flowchart according to the STARD guidelines.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4274711&req=5

fig2: Study design flowchart according to the STARD guidelines.

Mentions: The test-retest reproducibility was assessed using the Bland-Altman plot. Twenty subjects including 10 cases and 10 controls were administered MALT twice at an interval of a six hours. It was ensured that patients being evaluated were not on lactulose, lactitol, neomycin, or any sedative meanwhile. The test was administered by the same examiner. The scores of the first and the second session of MALT were compared. The report was prepared in accordance with standards for reporting diagnostic accuracy, STARD guidelines (Figure 2) [17].


The mind and liver test: a new approach to the diagnosis of minimal hepatic encephalopathy in resource-poor settings.

Das S, Ali SM, Seward J, Venkataraman J - Int J Hepatol (2014)

Study design flowchart according to the STARD guidelines.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4274711&req=5

fig2: Study design flowchart according to the STARD guidelines.
Mentions: The test-retest reproducibility was assessed using the Bland-Altman plot. Twenty subjects including 10 cases and 10 controls were administered MALT twice at an interval of a six hours. It was ensured that patients being evaluated were not on lactulose, lactitol, neomycin, or any sedative meanwhile. The test was administered by the same examiner. The scores of the first and the second session of MALT were compared. The report was prepared in accordance with standards for reporting diagnostic accuracy, STARD guidelines (Figure 2) [17].

Bottom Line: Results.Test-retest agreement was high (ICC = 0.89).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Gastroenterology, Stanley Medical College and Hospital, Chennai 600001, India.

ABSTRACT
Background and Aims. Minimal hepatic encephalopathy (MHE) is diagnosed using neuropsychometric tests or neurophysiological tests that are either inapplicable to illiterate patient population in resource-poor settings or require sophisticated and expensive equipment. The available tests assess discrete domains of mental impairment. Our aim was (a) to design a neuropsychometric test that measures all domains of mental impairment in MHE using one metric; (b) to evaluate its sensitivity, specificity, and reproducibility. Methods. The mind and liver test (MALT), a psychometric test assessing cognition, memory, and psychometric impairment, each on a scale of 20, was designed keeping in mind the requirements of a universal test. 40 cirrhotics and 36 controls were subjected to critical flicker frequency (CFF) and MALT in same sitting. ROC curve was plotted for MALT using CFF as gold standard. Bland-Altman plot was used to find test-retest agreement. Results. CFF values and MALT scores varied significantly between the cases and the controls (P < 0.05). MALT was 94% sensitive and 83% specific. Using ROC with CFF as gold standard, the AUC for diagnosis of MHE using MALT score was 0.89. Test-retest agreement was high (ICC = 0.89). Conclusion. In this pilot study, MALT proved to be highly sensitive, specific, inexpensive, and reproducible.

No MeSH data available.


Related in: MedlinePlus