Algorithms for assessing the probability of an Adverse Drug Reaction

Adverse Drug Reactions (ADRs) are common and are associated with significant risk of morbidity, mortality and admission to hospital. Deciding if a clinical event is an Adverse Drug Reaction, or not, can be difficult. The decision is often based on clinical judgment alone, yet studies have shown that decisions based on clinical judgment often vary greatly between raters.Therefore a number of decision aids or Algorithms have been developed to try and improve this variability. Studies have shown that the use of algorithms does improve the between and within rater agreement significantly, and gives a semi-quantitative measure of the likelihood of causality. There are variations between these algorithms but none of them can in themselves prove or disprove causality. These algorithms, their benefits and their problems will be discussed in this article.