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Expert opinion is often used in research and industry, but its test\u2013retest reliability is unknown. To determine the test\u2013retest reliability of the expert opinion process used by the Drug\u2010Induced Liver Injury Network (<jats:styled-content style=\"fixed-case\">DILIN<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three <jats:styled-content style=\"fixed-case\">DILIN<\/jats:styled-content> hepatologists adjudicate suspected hepatotoxicity cases to one of five categories representing levels of likelihood of <jats:styled-content style=\"fixed-case\">DILI<\/jats:styled-content>. Adjudication is based on retrospective assessment of gathered case data that include prospective follow\u2010up information. One hundred randomly selected <jats:styled-content style=\"fixed-case\">DILIN<\/jats:styled-content> cases were re\u2010assessed using the same processes for initial assessment but by three different reviewers in 92% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median time between assessments was 938\u00a0days (range 140\u20132352). Thirty\u2010one cases involved &gt;1 agent. Weighted kappa statistics for overall case and individual agent category agreement were 0.60 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.50\u20130.71) and 0.60 (0.52\u20130.68) respectively. Overall case adjudications were within one category of each other 93% of the time, while 5% differed by two categories and 2% differed by three categories. Fourteen per cent crossed the 50% threshold of likelihood owing to competing diagnoses or atypical timing between drug exposure and injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">DILIN<\/jats:styled-content> expert opinion causality assessment method has moderate interobserver reliability but very good agreement within one category. A small but important proportion of cases could not be reliably diagnosed as \u226550% likely to be <jats:styled-content style=\"fixed-case\">DILI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12540","type":"journal-article","created":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T02:53:00Z","timestamp":1395715980000},"page":"1623-1632","source":"Crossref","is-referenced-by-count":42,"title":["Reliability of causality assessment for drug, herbal and dietary supplement hepatotoxicity in the Drug\u2010Induced Liver Injury Network (<scp>DILIN<\/scp>)"],"prefix":"10.1111","volume":"35","author":[{"given":"Paul H.","family":"Hayashi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiman X.","family":"Barnhart","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute &amp; Department of Biostatistics Duke University Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Fontana","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naga","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Davern","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology California Pacific Medical Center San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant A.","family":"Talwalkar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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