{
  "abstract": "Introduction\n\nPatients with hepatic encephalopathy frequently visit the emergency department, and these visits are expected to rise in the coming years due to an increased prevalence of liver disease in the United States. Accordingly, we sought to define a comprehensive and efficient approach for emergency physicians to evaluate, treat, and determine the optimal disposition of patients presenting with possible or confirmed hepatic encephalopathy and its complications.Methods\n\nWe reached consensus recommendations through a structured literature review and a modified Delphi technique, informing an expert panel of academic and community emergency physicians convened by the American College of Emergency Physicians.Results\n\nWe created the assess, look, treat, evaluate risk, reassess, disposition (ALTERD) framework as a digital point-of-care tool to support clinicians in guiding key bedside steps involved in the diagnosis and care of patients across the spectrum of hepatic encephalopathy.Conclusion\n\nA collaborative expert panel process can create an emergency department-focused, easily accessible, and comprehensive digital tool to complement workflows and improve the care of a vulnerable and growing patient population.",
  "abstract_shown": true,
  "affiliations": [
    "Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts.",
    "Weill Cornell Medicine, Division of Gastroenterology and Hepatology, New York, New York.",
    "TeamHealth Lifepoint Group, Nashville, Tennessee.",
    "Mayo Clinic, Department of Pharmacy, Phoenix, Arizona.",
    "Jefferson Health, Division of Hospital Medicine, Abington, Pennsylvania.",
    "Ohio State University, Department of Emergency Medicine, Columbus, Ohio.",
    "Baylor College of Medicine, Henry J. N. Taub Department of Emergency Medicine, Houston, Texas.",
    "University of California, Irvine, Department of Medicine, Irvine, California."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Christopher W Baugh"
    },
    {
      "affs": [
        1
      ],
      "name": "Arun B Jesudian"
    },
    {
      "affs": [
        2
      ],
      "name": "Stanley C Thompson"
    },
    {
      "affs": [
        3
      ],
      "name": "Christi Jen"
    },
    {
      "affs": [
        4
      ],
      "name": "William Ford"
    },
    {
      "affs": [
        5
      ],
      "name": "James F Neuenschwander"
    },
    {
      "affs": [
        6
      ],
      "name": "Edgardo Ordonez"
    },
    {
      "affs": [
        7
      ],
      "name": "Alpesh N Amin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bbr7445z9fjn7.bib",
  "cited_by": 0,
  "doi": "10.5811/westjem.63064",
  "fulltext_url": "https://europepmc.org/articles/PMC13660559",
  "id": "bbr7445z9fjn7",
  "issns": [
    "1936-900X",
    "1936-9018"
  ],
  "landing_url": "https://europepmc.org/article/MED/42900941",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7203652522",
  "pdf_url": "https://europepmc.org/articles/PMC13660559?pdf=render",
  "pmcid": "PMC13660559",
  "pmid": "42900941",
  "published": "2026-08-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bbr7445z9fjn7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42900941",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42900941"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Emergency Department Evaluation and Care of Hepatic Encephalopathy: ACEP Expert Panel Recommendations.",
  "title_text": "Emergency Department Evaluation and Care of Hepatic Encephalopathy: ACEP Expert Panel Recommendations.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:41Z",
  "url": "https://research.draconitic.com/paper/bbr7445z9fjn7",
  "venue": "The western journal of emergency medicine",
  "versions": []
}