title: Dilemmas of the causality assessment tools in the diagnosis of adverse drug reactions.
abstract: OBJECTIVE
  Basic essence of Pharmacovigilance is prevention of ADRs and its precise diagnosis is crucially a primary step, which still remains a challenge among clinicians.
  
  
  OBJECTIVE
  This study is undertaken with the objective to scrutinize and offer a notion of commonly used as well as recently developed methods of causality assessment tools for the diagnosis of adverse drug reactions and discuss their pros and cons.
  
  
  METHODS
  Overall 49 studies were recognized for all assessment methods with five major decisive factors of causality evaluation, all the information regarding reasons allocating causality, the advantages and limitations of the appraisal methods were extracted and scrutinized.
  
  
  RESULTS
  From epidemiological information a past prospect is designed and subsequent possibility merged this background information with a clue in the individual case to crop up with an approximation of causation. Expert judgment is typically based on the decisive factor on which algorithms are based, nevertheless in imprecise manner. The probabilistic methods use the similar principle; however connect probabilities to each measure. Such approaches are quite skeptical and liable to generate cloudy causation results. Causation is quite intricate to ascertain than correlation in Pharmacovigilance due to numerous inherent shortcomings in causality assessment tools.
  
  
  CONCLUSIONS
  We suggest that there is a need to develop a high quality assessment tool which can meticulously establish suitable diagnostic criteria for ADRs with universal acceptance to improvise the fundamental aspect of drug safety and evade the impending ADRs with the motive to convert Pharmacovigilance into a state of art.
authors.affiliation: Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia.
authors.forename: Lateef M
authors.initials: LM
authors.lastname: Khan
authors.affiliation: Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia.
authors.forename: Sameer E
authors.initials: SE
authors.lastname: Al-Harthi
authors.affiliation: Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia; National Cancer Institute, Cairo University, Egypt.
authors.forename: Abdel-Moneim M
authors.initials: AM
authors.lastname: Osman
authors.affiliation: Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia; Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mai A Alim A
authors.initials: MA
authors.lastname: Sattar
authors.affiliation: Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Ali
keywords: Adverse drug reactions; Algorithms; Causality assessment tools; Pharmacovigilance