Abstract
It remains challenging to identify covert hepatic encephalopathy and predict progression to overt hepatic encephalopathy. Psychometric testing is a widely used diagnostic modality, but it is often inaccurate and difficult to implement in diverse populations, making it a less than ideal assessment. Alternatively, by using easily accessible data from the electronic health record, simple clinical assessment tools, and patient-reported outcomes, we may be better able to predict hepatic encephalopathy across multiple populations. Furthermore, incorporation of patient-reported outcomes into our diagnostic toolset not only aids detection of covert hepatic encephalopathy and prediction of overt hepatic encephalopathy, but also allows us to target therapies and track their impact. Herein, we outline a potential algorithm based on these easily integrated tools to promote patient risk-stratification and early therapeutic intervention.
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Elliot Tapper receives funding from the National Institutes of Health through K23DK117055 and U01DK130113.
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Elliot Tapper has served as a consultant to Allergan, Novartis, Novo Nordisk, and Mallinckrodt, has served on advisory boards for Rebiotix, Mallinckrodt, Bausch, Kaleido, and has received research grants from Gilead and Valeant.
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Saleh, Z.M., Tapper, E.B. Predicting which patients with cirrhosis will develop overt hepatic encephalopathy: Beyond psychometric testing. Metab Brain Dis 38, 1701–1706 (2023). https://doi.org/10.1007/s11011-022-01112-3
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DOI: https://doi.org/10.1007/s11011-022-01112-3