The Neuropsychological Laboratory, CNS-Fed, Paris, France.
Service de Médecine et de Réadaptation Gériatrique et Neurologique, Hôpitaux de Saint-Maurice, Saint-Maurice, France.
PLoS One. 2021 Sep 10;16(9):e0257136. doi: 10.1371/journal.pone.0257136. eCollection 2021.
The Psychometric Hepatic Encephalopathy Score (PHES) has previously been standardized in thirteen countries on three continents, confirming its status of gold standard test to detect minimal hepatic encephalopathy (MHE). In the meantime, performance has also been shown to vary with variables such as age, education, and barely sex. The present study aimed at standardizing the PHES in a French population. One hundred and ninety-six French healthy participants completed a French version of the paper-and-pencil PHES, involving five tests and six measures. Importantly, the balance was perfect between all levels of the three controlled factors, which were sex, age (seven decade-levels from 20-29 to 80-89 years), and education (two levels below or above 12 years of education). Raw measures were transformed to fit the normal distribution. ANOVAs on transformed variables showed no effect of sex, but an effect of age on all measures, and of education on five measures. Multiple or simple regressions were completed to build up normograms. Thorough analysis of variability within each test failed to find outliers that may bias the results. Comparison between French and seminal German data showed that they highly fitted though cultural and cognitive style specificities could be observed. This is the first study to standardize the PHES in a French population and to extensively explore the effects of sex, age and education using perfectly balanced samples. Subtle differences between countries of the same continent emphasize the need to build up normative data in each country to get accurate PHES in patients.
心理性肝性脑病评分（PHES）先前已在三大洲的十三个国家进行了标准化，证实其是检测轻微肝性脑病（MHE）的金标准测试。同时，其性能也已证明会因年龄、教育程度和性别等变量而有所不同。本研究旨在对法国人群进行 PHES 标准化。196 名法国健康参与者完成了纸笔版 PHES 的法语版本，涉及五项测试和六项指标。重要的是，三个控制因素（性别、年龄（20-29 岁至 80-89 岁七个十年水平）和教育程度（低于或高于 12 年教育的两个水平）的所有水平之间的平衡都非常完美。原始指标被转换为适合正态分布。转换后的变量的方差分析显示，性别无影响，但所有指标的年龄有影响，五项指标的教育程度有影响。完成了多元或简单回归以建立正态图表。对每个测试内的变异性进行彻底分析，未发现可能导致结果偏差的异常值。法国和德国主要数据的比较表明，它们高度匹配，尽管可以观察到文化和认知风格的特异性。这是首次在法国人群中对 PHES 进行标准化的研究，并使用完全平衡的样本广泛探讨了性别、年龄和教育的影响。同一大陆不同国家之间的细微差异强调需要在每个国家建立规范数据，以在患者中获得准确的 PHES。
