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. 2019 May 30;28(1):47–49. doi: 10.1136/ejhpharm-2018-001849

Table 3.

WHO–UMC causality categories

Assessment criteria Causality term
Event or laboratory test abnormality, with plausible time relationship to drug intake
Cannot be explained by disease or other drugs
Response to withdrawal plausible (pharmacologically, pathologically)
Event definitive pharmacologically or phenomenologically (ie, an objective and specific medical disorder or a recognised pharmacological phenomenon)
Rechallenge satisfactory, if necessary
Certain
Event or laboratory test abnormality, with reasonable time relationship to drug intake
Unlikely to be attributed to disease or other drugs
Response to withdrawal clinically reasonable
Rechallenge not required
Probable/Likely
Event or laboratory test abnormality, with reasonable time relationship to drug intake
Could also be explained by disease or other drugs
Information on drug withdrawal may be lacking or unclear
Possible
Event or laboratory test abnormality
More data for proper assessment needed, or
Additional data under examination
Conditional/Unclassified
Event or laboratory test abnormality, with a time to drug intake that makes a relationship improbable (but not impossible)
Disease or other drugs provide plausible explanations
Unlikely
Report suggesting an adverse reaction
Cannot be judged because information is insufficient or contradictory
Data cannot be supplemented or verified
Unassessable/Unclassifiable