Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis
Abstract
:1. Introduction
2. Pathogenesis
3. Clinical Picture
4. Diagnosis of Minimal Hepatic Encephalopathy
4.1. Paper-Pencil and Computerized Psychometric Tests
4.1.1. Psychometric Hepatic Encephalopathy Score (PHES)
4.1.2. EncephalApp_Stroop
4.1.3. Other Strategies Adapted for Testing for MHE
4.2. Detection of Changes in Brain Physiology
Test | Sensitivity (%) | Specificity (%) | AUROC (%) | Ease of Use | Time Requirement | Gold Standard Used for Comparison |
---|---|---|---|---|---|---|
PHES [20,22] | 45–57 | 85–97 | - | Simple | 10–20 min | EEG |
ANT [37] | 78.0 | 63.0 | - | Simple | 1 min | PHES |
Stroop test [32] | 94.0 | 79.0 | 91.0 | Simple | <5 min [42] | SPTs |
CFF [43] | 61.0 | 79.0 | 84.0 | Intermediate [42] | 5–15 min [42] | This was a meta-analysis |
ICT [44] | 87.0 | 77.0 | 90.2 | Intermediate [42] | 14 ± 3 | SPTs |
CRT [39] | 93.0 | 92.0 | - | Intermediate | 10 min | Missing |
5. Artificial Intelligence
5.1. Existing Application of Artificial Intelligence to MHE Diagnosis
5.2. Outlook for the Further Application of Artificial Intelligence to MHE Diagnosis
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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ISHEN | WHC | Description | Suggested Operative Criteria |
---|---|---|---|
Unimpaired | No Encephalopathy at All, No History of HE | Tested and Proved to be Normal | |
Covert | Minimal | Psychometric or neuropsychological alterations of tests exploring psychomotor speed/executive functions or neurophysiological alterations without clinical evidence of mental change. | Abnormal results of established psychometric or neuropsychological tests without clinical manifestations |
Grade I |
| Despite oriented in time and space (see below), the patient appears to have some cognitive/behavioural decay with respect to his/her standard on clinical examination, or to the caregivers | |
Overt | Grade II |
| Disoriented for time (at least three of the followings are wrong: day of the month, day of the week, month, season or year) ± the other mentioned symptoms |
Grade III |
| Disoriented also for space (at least three of the following wrongly reported: country, state [or region], city or place) ± the other mentioned symptoms | |
Grade IV | Coma | Does not respond even to pain stimuli |
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Gazda, J.; Drotar, P.; Drazilova, S.; Gazda, J.; Gazda, M.; Janicko, M.; Jarcuska, P. Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis. J. Pers. Med. 2021, 11, 1090. https://doi.org/10.3390/jpm11111090
Gazda J, Drotar P, Drazilova S, Gazda J, Gazda M, Janicko M, Jarcuska P. Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis. Journal of Personalized Medicine. 2021; 11(11):1090. https://doi.org/10.3390/jpm11111090
Chicago/Turabian StyleGazda, Jakub, Peter Drotar, Sylvia Drazilova, Juraj Gazda, Matej Gazda, Martin Janicko, and Peter Jarcuska. 2021. "Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis" Journal of Personalized Medicine 11, no. 11: 1090. https://doi.org/10.3390/jpm11111090