Hans L Tillmann1, Huiman X Barnhart2, Jose Serrano3, Don C Rockey4. 1. Division of Gastroenterology, East Carolina University, Greenville, NC. 2. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. 3. NIDDK, Liver Branch, Bethesda, MD. 4. Department of Medicine, Medical University South Carolina, Charleston, SC.
Abstract
PURPOSE OF REVIEW: Drug induced liver injury (DILI) is a complex diagnosis dominantly based of exclusion. RECENT FINDINGS: Currently available causality assessment instruments are considered to be suboptimal. Expert opinion appears to be best method to adjudicate causality, but is impractical to implement on a wide scale basis. Thus, new approaches are needed, for example improving the specificity of current scoring systems. A further option would be to develop a system that utilizes computer-based scoring - which would reduce human error. Additionally, it would be ideal to have available drug specific scoring systems, based on drugs' characteristic "phenotypes" (presentation and pattern of injury). Eventually, a validated system could be integrated within the electronic health information system. SUMMARY: This review highlights an avenue to an improved Causality Assessment Tool.
PURPOSE OF REVIEW: Drug induced liver injury (DILI) is a complex diagnosis dominantly based of exclusion. RECENT FINDINGS: Currently available causality assessment instruments are considered to be suboptimal. Expert opinion appears to be best method to adjudicate causality, but is impractical to implement on a wide scale basis. Thus, new approaches are needed, for example improving the specificity of current scoring systems. A further option would be to develop a system that utilizes computer-based scoring - which would reduce human error. Additionally, it would be ideal to have available drug specific scoring systems, based on drugs' characteristic "phenotypes" (presentation and pattern of injury). Eventually, a validated system could be integrated within the electronic health information system. SUMMARY: This review highlights an avenue to an improved Causality Assessment Tool.
Entities:
Keywords:
Causality; Drug induced liver injury; liver disease; scoring system
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