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Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment
Rolf Teschke, Alexander Schwarzenboeck, Axel Eickhoff, Department of Internal Medicine II, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University of Frankfurt/Main, D-63450 Hanau, Germany
Albrecht Wolff, Department of Internal Medicine II, Division of Gastroenterology, Hepatology and Infectious Diseases, Friedrich Schiller University Jena, D-07743 Jena, Germany
Christian Frenzel, Department of Medicine I, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
Johannes Schulze, Institute of Industrial, Environmental and Social Medicine, Medical Faculty, Goethe University, 60590 Frankfurt/Main, Germany
Author contributions: Teschke R and Eickhoff A provided substantial contributions to the conception and design; Wolff A, Frenzel C and Schwarzenboeck A contributed to the literature search and acquisition of relevant literature; Teschke R, Schulze J and Eickhoff A contributed to analysis and interpretation of the data; Teschke R contributed to drafting the article; Wolff A, Frenzel C, Schwarzenboeck A, Schulze J and Eickhoff A contributed to revising it critically for important intellectual content; all the authors contributed to final approval of the version to be published.
Correspondence to: Rolf Teschke, MD, Professor of Medicine, Department of Internal Medicine II, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University of Frankfurt/Main, Leimenstrasse 20, D-63450 Hanau, Germany. rolf.teschke@gmx.de
Telephone: +49-6181-21859 Fax: +49-6181-2964211
Received: August 2, 2013
Revised: November 11, 2013
Accepted: December 9, 2013
Published online: January 27, 2014
Revised: November 11, 2013
Accepted: December 9, 2013
Published online: January 27, 2014
Core Tip
Core tip: We propose that the attending physicians caring for patients with assumed drug induced liver injury and herb induced liver injury should use the Council for International Organizations of Medical Sciences (CIOMS) scale for causality assessment. This approach includes the option of subsequent refinement of the CIOMS based results by expert panels and regulatory agencies. The use of the CIOMS scale as an identical tool for all involved parties will allow early and prospective collection of all relevant data required for a valid causality assessment in clinical hepatology.