Flicker App for Minimal Hepatic Encephalopathy

  • End date
    Jun 30, 2023
  • participants needed
  • sponsor
    University of Washington
Updated on 16 January 2022
liver disease
screening procedures
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

Condition Hepatic Encephalopathy
Treatment Critical flicker frequency
Clinical Study IdentifierNCT04415294
SponsorUniversity of Washington
Last Modified on16 January 2022


Yes No Not Sure

Inclusion Criteria

Cirrhosis (standard criteria)
Chronic liver disease

Exclusion Criteria

Grade III or IV hepatic encephalopathy
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)
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