title: Do the national survey results reflect the state of drug-induced liver injury in a single local city in which there is no hospital having Members of the Board of Councilors of the Japan Society of Hepatology? Results of a questionnaire survey conducted in a local city.
abstract: OBJECTIVE
  This survey aims at clarifying if there are common features of drug-induced liver injury (DILI) in local areas and in the national surveys, and the degree of dissemination of the new diagnostic criteria (JDDW scale) proposed during the Japan Digestive Disease Week (JDDW) in 2004 and Manual for Serious Side-Effects of DILI (Manual) published in April 2008.
  
  
  METHODS
  An anonymous questionnaire for DILI was conducted for 6 weeks starting on 20 October 2008. The participants were 179 medical doctors. One hundred and fifty-seven of them belonged to the Medical Association of Nakatsu City (population: 86 000 persons), which is located in northern Kyushu, and 22 physicians working in a core hospital, Nakatsu Municipal Hospital.
  
  
  RESULTS
  Seventy-four percent of the responding doctors with 13 various specialties had experienced DILI cases. The three most frequent causative drugs were antibiotics, folk medicines and drugs for the circulatory system. DILI associated with folk medicines was encountered mostly after 2000. The doctors' recognition of the JDDW scale and Manual were as low as 17% and 29%, respectively.
  
  
  CONCLUSIONS
  This survey revealed that the results of the national investigations conducted by the Japan Society of Hepatology (JSH) reflect the current state of DILI in local areas in which there is no hospital with Members of the Board of Councilors of the JSH. Widespread utilization of the Manual and JDDW scale by local doctors must be facilitated for early diagnosis of DILI and the prevention of severe conditions.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka Hisamochi Medical Office, Nakatsu, Oita, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Hisamochi
authors.forename: Ryukichi
authors.initials: R
authors.lastname: Kumashiro
authors.forename: Michio
authors.initials: M
authors.lastname: Sata