药物性肝病因果关系判定的新方法
Novel Approaches to Causality Adjudication in Drug-Induced Liver Disease.
作者信息
Tillmann Hans L, Barnhart Huiman X, Serrano Jose, Rockey Don C
机构信息
Division of Gastroenterology, East Carolina University, Greenville, NC.
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
出版信息
Curr Hepatol Rep. 2018 Sep;17(3):276-282. doi: 10.1007/s11901-018-0416-8. Epub 2018 Jul 11.
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.
综述目的
药物性肝损伤（DILI）是一种主要基于排除法的复杂诊断。
最新发现
目前可用的因果关系评估工具被认为不够理想。专家意见似乎是判定因果关系的最佳方法，但在大规模实施时不切实际。因此，需要新的方法，例如提高当前评分系统的特异性。另一种选择是开发一种利用计算机评分的系统，这将减少人为误差。此外，基于药物的特征“表型”（损伤表现和模式）建立药物特异性评分系统将是理想的。最终，一个经过验证的系统可以集成到电子健康信息系统中。
总结
本综述强调了改进因果关系评估工具的途径。
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