Advances in Roussel Uclaf Causality Assessment Method for diagnosis of drug-induced liver injury and its comparison with structured expert opinion process

Up to now,the diagnosis of drug- induced liver injury( DILI) still relies on the exclusive method,and the Roussel Uclaf Causality Assessment Method( RUCAM) is the most commonly used scale. Since the release of the first version of RUCAM scale in 1993,the second version was released in 2015,in which the definition and scoring criteria of each key element were revised appropriately and explained in detail. The Structured Expert Opinion Process( SEOP) was designed by the workgroup of DILI network prospective study,but since it is too complicated and time- and energy- consuming,its application in clinical practice is limited. This article introduces the research and development history and application method of RUCAM,as well as the modifications made in the 2015 version of RUCAM,and briefly compares the difference in bias between RUCAM and SEOP in the diagnosis of DILI. It is pointed out that both RUCAM and SEOP have marked interobserver and intraobserver variabilities,and therefore,it is necessary to explore a more objective,reproducible,accurate,and convenient strategy for the diagnosis of DILI.