Flicker App for Minimal Hepatic Encephalopathy
Flicker App for Minimal Hepatic Encephalopathy
There is a great unmet clinical need for improved screening for MHE in patients with
 cirrhosis. We will demonstrate that the Flicker-App can be used in clinic as well as at home
 by patients with cirrhosis to measure CFF, a proven screening test for MHE. We will optimize
 the protocol, software, and hardware of the Flicker-App to create a product appropriate for
 production and distribution to patients
SA 1. Determine whether cirrhotic patients (n=75) can self-administer the Flicker-App in
 clinic supervised by a research assistant and calculate the level of agreement between the
 CFF determined by the Flicker-App, the CFF determined by the "gold-standard" FFS device, and
 the test scores on the EncephalApp Stroop test.

 SA 2. Determine whether cirrhotic patients (n=75) can self-administer the Flicker-App at
 home, including daily measurements over 1 week and weekly measurements over 6 weeks, and
 calculate the adherence to this protocol and the variability of these CFF measurements.

 SA3. Make any necessary software or hardware adjustments to the Flicker-App to facilitate and
 simplify its self-administration by patients based on structured interview-questionnaires
 with the study participants and with clinical Gastroenterologists/Hepatologists
Inclusion Criteria:

 -  Cirrhosis (standard criteria) and either no evidence of overt hepatic encephalopathy
 (OHE) or prior OHE or current grade II OHE

 Exclusion Criteria:

 -  Grade III or IV OHE, Mini-mental state examination score ≤25 (suggestive of dementia);
 alcohol or illicit drug use within 3 months; current use of benzodiazepines,
 antiepileptics or psychotropic drugs; color blindness; severe vision impairment
 (blindness, macular degeneration).