Table 1.

Scoring Systems Applied to Diagnose DILI.

Scoring system	Scoring criteria (score)	Major biomarkers	Comments
RUCAM (Danan and Benichou, 1993; Garcia-Cortes et al., 2011; Danan and Teschke, 2018)	• Highly probable (> 8) • Probable (6–8) • Possible (3–5) • Unlikely (1–2) • Excluded (≤0)	• ALT • ALP	• It is an objective, standardized, and liver-injury-specific approach. • Its poor reliability and arbitrary scoring are questioned, such as alcohol use.
CDS (Maria and Victorino, 1997)	• Definite (> 17) • Probable (14–17) • Possible (10–13) • Unlikely (6–9) • Excluded (< 6)	• ALT • ALP	• It does not consider the pattern of liver injury, which often results in false diagnosis with cholestatic DILI.
DDW-J (Watanabe and Shibuya, 2004; Tajiri and Shimizu, 2008; Hanatani et al., 2014)	• Definite (≥5) • Probable (3–4) • Unlikely (≤2)	• ALT • ALP • Eosinophilic granulocyte	• Highly sensitive in Japanese patients; however, not evaluated in other populations.

RUCAM, Roussel Uclaf Causality Assessment Method; CDS, Clinical Diagnostic Scale; DDW-J, the Digestive Disease Week Japan 2004.