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The World Health Organisation-Uppsala Monitoring Centre (WHO-UMC) system has been developed as a practical tool for the assessment of case reports. 

 

The table below lists the various causality categories and their assessment criteria that have been developed under this system.

 

Table: WHO-UMC Causality Categories; Source: WHO-UMC System for Standardised Case Causality Assessment, p2.
CAUSALITY TERM/ CATEGORY​ ASSESSMENT CRITERIA​
Certain/ Very Likely​
  • 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 (i.e., an objective and specific medical disorder or a recognized pharmacological phenomenon) ​
  • Rechallenge satisfactory, if necessary ​
Probable/ Likely ​
  • 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 ​
Possible​
  • 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​
Unlikely​
  • 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 ​
Conditional/ Unclassified ​
  • Event or laboratory test abnormality​
  • More data for proper assessment is needed, or additional data under examination ​
Unassessable/ Unclassifiable​
  • Report suggesting an adverse reaction​
  • Cannot be judged because the information is insufficient or contradictory​
  • Data cannot be supplemented or verified​

 

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