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Cited by 6

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Improving the Diagnostic Accuracy of RECAM in North American Patients With Suspected Idiosyncratic Drug-Induced Liver Injury

Ciricillo, Jacob, Myer, Adam, Yeboah-Korang, Amoah, Osman, Askanda, Rahim, Farrah, Goldfarb, David G., Sharma, Yeshika, Louissaint, Jeremy, Sherman, Kenneth E., Fontana, Robert J.·2025·American Journal of Gastroenterology
DOI 10.14309/ajg.0000000000003147
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Abstract

INTRODUCTION: The Revised Electronic Causality Assessment Method (RECAM) is an updated, electronic version of the Roussel Uclaf Causality Assessment Method (RUCAM) to diagnose drug-induced liver injury (DILI). The primary aim of this study was to compare RECAM vs RUCAM in patients with suspected DILI. METHODS: Patient encounters from October 1, 2015, to September 30, 2019, were searched for suspected DILI using ICD-10 K71 codes for toxic liver disease. DILI Network (DILIN) expert opinion scores were assigned to each case (1/2/3 = probable DILI, 4/5 = non-DILI). RECAM and RUCAM scores were compared with DILIN expert opinion scores. RESULTS: Among 766,930 encounters searched, 120 unique patients met inclusion criteria with 72 (60%) adjudicated as probable-DILI. The most frequent suspect drugs were antimicrobials (38.3%), antineoplastics (8.3%), and antirheumatic drugs (8.3%). The mean age was 49.2 + 15.6 years, and 50% were female with 45.8% having hepatocellular injury. RUCAM had better agreement with DILIN expert opinion for probable-DILI vs RECAM (66.7% vs 44.4%, P = 0.018). Both had 100% agreement with DILIN expert opinion for non-DILI. Frequently missing laboratory data included hepatitis C virus (HCV) RNA (64.3%) and antihepatitis E virus (HEV) immunoglobulin M (IgM) testing (70%), leading to loss of up to 6 points in RECAM scoring but not affecting RUCAM scores. A modified RECAM that made HCV RNA and anti-HEV IgM optional had better agreement with DILIN expert opinion compared with RUCAM (79.2% vs 66.7%, P = 0.09). DISCUSSION: Among 120 suspected DILI cases, RUCAM had better agreement with DILIN expert opinion scores vs RECAM. Making HCV RNA and anti-HEV IgM testing optional significantly improved agreement between RECAM and DILIN expert opinion. Future modifications to RECAM are needed to improve causality assessment in North American patients with suspected DILI.

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Citations

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Research works printed but not linked: 22

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Metadata

Authors
Ciricillo, J., Myer, A., Yeboah-Korang, A., Osman, A., Rahim, F., Goldfarb, D. G., Sharma, Y., Louissaint, J., Sherman, K. E., & Fontana, R. J.
Affiliations
  • Division of Digestive Diseases, University of Cincinnati Medical Center, Cincinnati, Ohio, USA;
  • Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Brooklyn, New York, USA;
  • Division of Gastroenterology and Hepatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA;
  • Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan, USA.
ORCID
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2024-10-18
Volume
120
Issue
6
Pages
1325-1333
ISSN
  • 0002-9270
  • 1572-0241
DOI
10.14309/ajg.0000000000003147
Cited by
6
References
6
Language
en
Funders
American Association for the Study of Liver Diseases (2018 AASLD Foundation Advanced/Transplant Hepatology Grant)

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CoChat. (2026). Citation check: Improving the Diagnostic Accuracy of RECAM in North American Patients With Suspected Idiosyncratic Drug-Induced Liver Injury. https://app.cochat.ai/papers/10.14309/ajg.0000000000003147
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Ciricillo, J., Myer, A., Yeboah-Korang, A., Osman, A., Rahim, F., Goldfarb, D. G., Sharma, Y., Louissaint, J., Sherman, K. E., & Fontana, R. J. (2025). Improving the Diagnostic Accuracy of RECAM in North American Patients With Suspected Idiosyncratic Drug-Induced Liver Injury. American Journal of Gastroenterology. https://doi.org/10.14309/ajg.0000000000003147

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