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Novel Approaches to Causality Adjudication in Drug-Induced Liver Disease

  • Drug-Induced Liver Injury (NP Chalasani and MS Ghabril, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

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 electronic health information systems.

Summary

This review highlights an avenue to an improved causality assessment tool.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, East Carolina University, Vidant Medical Center, Suite 338, Mail Stop 734, Greenville, NC, USA

    Hans L. Tillmann

  2. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA

    Huiman X. Barnhart

  3. NIDDK, Liver Branch, Bethesda, MD, USA

    Jose Serrano

  4. Department of Medicine, Medical University South Carolina, Charleston, SC, USA

    Don C. Rockey

Authors
  1. Hans L. Tillmann
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  2. Huiman X. Barnhart
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  3. Jose Serrano
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  4. Don C. Rockey
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Contributions

Hans L. Tillmann—concept and drafting of the manuscript; critical revision of the manuscript for important intellectual content

Huiman X. Barnhart—drafting of the manuscript; critical revision of the manuscript for important intellectual content

Jose Serrano—drafting of the manuscript; critical revision of the manuscript for important intellectual content

Don C. Rockey—drafting of the manuscript; critical revision of the manuscript for important intellectual content, supervisory efforts

Corresponding author

Correspondence to Hans L. Tillmann.

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Conflict of Interest

Hans L. Tillmann reports that his spouse is a full-time employee of AbbVie, reports grants from NIH-NIDDK, during the conduct of the study, reports personal fees from AbbVie, Abbott, and Gilead from stocks, and reports personal fees from Novartis and Novo Nordisk for consulting, outside the submitted work; Huiman X. Barnhart, Jose Serrano, and Don C. Rockey declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Drug-Induced Liver Injury

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Tillmann, H.L., Barnhart, H.X., Serrano, J. et al. Novel Approaches to Causality Adjudication in Drug-Induced Liver Disease. Curr Hepatology Rep 17, 276–282 (2018). https://doi.org/10.1007/s11901-018-0416-8

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  • DOI: https://doi.org/10.1007/s11901-018-0416-8

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