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Kircheis and coauthors suggest ‘inadequate handling of the test’ as reason for the worse sensitivity of the Critical Flicker Frequency (CFF) for diagnosing hepatic encephalopathy (HE) compared with other methods evaluated in our study.1 ,2 Their main criticism aims at our finding of CFF above 50 Hz in healthy controls. They argue that flicker frequencies above 50 Hz ‘cannot be sensed and therefore are invisible for the naked eye …’ referring to a review by Shady et al3 In fact, Shady et al do not give a clear cut-off at 50 Hz but indicate that ‘… the temporal resolution of a typical observer is limited to a CFF of ≈50 for luminance flicker’. CFF depends on several parameters, such as luminance, wavelength and luminous intensity. In everyday life, the experience of CFF thresholds above …
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