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Stroop test app screens for cognitive dysfunction

A dysfunction found in some patients with cirrhosis is normally difficult to diagnose due to extremely subtle symptoms. But a free smartphone app could change that.

The iPhone and iPad app is free and available in several languages. Jasmohan Bajaj

In patients with cirrhosis, a cognitive dysfunction called hepatic encephalopathy can sometimes arise, causing altered levels of consciousness, confusion, and sometimes, in advanced stages, even coma and death.

Now a smartphone app developed to help diagnose the milder minimal hepatic encephalopathy -- which has until now been almost impossible to diagnose due to the extremely subtle symptoms -- has been found to be a fast and effective screening tool, according to a new Virginia Commonwealth University (VCU) study published in the September issue of Hepatology.

Called EncephalApp_Stroop, the app could ultimately be used as a point-of-care tool for providers to quickly and easily diagnose and evaluate patients who might be suffering from the dysfunction.

"This app can be used to rapidly select which patients are likely to benefit from further MHE testing and potential treatment, which has been lacking at this time," principal investigator Jasmohan Bajaj, who practices at VCU and McGuire VA Medical Centers, said in a school news release.

The free app that Bajaj developed, which is in English, Spanish, Czech, Slovak, and Indonesian languages, walks users through the Stroop test, which shows a combination of ink colors and words to evaluate a person's cognitive abilities. To test it, Bajaj and his team used the app on 169 patients with cirrhosis and 51 who served as healthy controls. All underwent several recommended cognitive tests, including the Stroop app test.

While the researchers say the app needs to be tested further in more people, they say it proved to be a very reliable method for screening for MHE in this population. Since treatment rates are so low in patients with MHE -- because it is so hard to diagnose -- the app may go a long way in helping people be diagnosed, treated, and monitored.