Identification of Hepatic Encephalopathy in Patients with Liver Cirrhosis Using the Tablet-Based OCS-Plus Test

Introduction and Objectives Hepatic encephalopathy (HE) is a common complication of liver cirrhosis, leading to reduced quality of life and increased mortality even in its early stages. However, diagnosing minimal HE is challenging, as it requires specialized psychometric testing. Tablet-based tools such as the Oxford Cognitive Screening Plus (OCS-Plus) may offer a time-efficient and delegable alternative. Methods In a prospective study, 103 patients with liver cirrhosis without manifest HE were examined at the University Hospital Jena. In addition to established paper-based psychometric tests, the OCS-Plus and measurement of critical flicker frequency (CFF) were used. Results The median age of the study participants was 63 years, and 59.2% were male. The main causes of cirrhosis were alcohol (49.5%) and MASLD (24.3%). The median MELD score was 11 points. The OCS-Plus could be successfully administered in 95 patients (average duration: 22.7 minutes). Significant deviations from normative values were observed particularly in the subtests “Word Memory,” “Cancellation,” and “Trails.” OCS-Plus results showed significant correlations with the performance on number connection tests (p