Purpose of review: Drug induced liver injury (DILI) is a complex diagnosis dominantly based of exclusion.
Recent findings: Currently available causality assessment instruments are considered to be suboptimal. Expert opinion appears to be best method to adjudicate causality, but is impractical to implement on a wide scale basis. Thus, new approaches are needed, for example improving the specificity of current scoring systems. A further option would be to develop a system that utilizes computer-based scoring - which would reduce human error. Additionally, it would be ideal to have available drug specific scoring systems, based on drugs' characteristic "phenotypes" (presentation and pattern of injury). Eventually, a validated system could be integrated within the electronic health information system.
Summary: This review highlights an avenue to an improved Causality Assessment Tool.
Keywords: Causality; Drug induced liver injury; liver disease; scoring system.