Comparison of two clinical scales for the diagnosis of drug-induced liver disease / 中华消化杂志

ABSTRACT

Objective To compare the consistency of 2 methods,RUCAM and CDS,for assessment of drug-induced liver injury and their sensitivity and specificity.Methods A total of 332 patients with drug-induced liver disease,who admitted to the first hospital of Zhejiang university from January 2000 to December 2006,were retrospectively evaluated.The data were collected from patients including clinical presentation,liver function,etc.The liver function and the outcome of the patients after treatment were also observed.The probability of the diagnosis was classified as definitive,probable,possible,unlikely,or excluded.The consistency,the specificity and sensitivity of two methos were evaluated with Spearman correlation analysis.Results Absolute agreement between the 2 scales was observed in 91 cases(27.41%),with disagreement of 1 level in 219 cases(65.96%),and of 2 levels in 22 cases(6.63%),which showed a positive correlateion(r=0.485,P=0.001).Absolute agreement between the 2 scales was observed in 12 cases of severe drug-induced liver disease(18.46%)(r=0.578,P=0.001)and in 79 cases of minor drug-induced liver disease(29.59%)(r=0.382,P=0.001).The specificity of CDS was 100%,and the sensitivity was 57%and 25%in diagnosis of severe and minor drug-induced liver disease,respectively.Conclusions The best correlation between the 2 scales was obtained for drug-induced liver injury.The RUCAM scale showed better sensitivity,especially in diagnosis of server drug-induced liver disease.