Response to Teschke et al.

摘要

The review by Teschke et al. reanalyzed a selected group of 22 spontaneous reports from regulatory agencies for the causal relationship between the use of black cohosh-containing products and hepatotoxicity and concluded that an "updated" Council for International Organizations of Medical Sciences (CIOMS) scale should replace the liver-unspecific Naranjo scale. The "update" referred to by the author is not originated by the CIOMS but includes the authors' modifications to the scale. On the basis of their new approach, the authors conclude that causality for black cohosh-mediated liver damage is "unlikely or excluded."