Table 4.

Advantages and limitations of RUCAM.

Advantages of RUCAM

Structured and quantitative, liver specific method Prospective use and timely decision Stepwise clinical approach User-friendly and cost-saving method No need of an expert panel Timely use at bedside Clearly defined key items of clinical features and course Full consideration of comedication(s) and alternative causes Consideration is given to prior known hepatotoxicity Incorporation of results of unintentional reexposure Individual scoring system of all key items Validated method (gold standard) Worldwide use □ International registries □ Regulatory agencies □ Pharma companies □ DILI published case reports and case series Transparent documentation Possible, step by step, reevaluation of DILI cases by peers

Limitations of RUCAM

RUCAM was not designed for suspected chronic DILI, which is mostly an unrecognized preexisting liver disease RUCAM may require help from expert hepatologists when a suspected DILI occurs on a complicated preexisting liver disease.

Additional details are provided in a recent article [3]. Abbreviations: DILI, Drug induced liver injury; RUCAM, Roussel Uclaf Causality Assessment Method.