TERMS of DILI RECAM USE The RECAM is a scoring algorithm to aid in the diagnosis of idiosyncratic drug-induced liver injury (DILI). It is an evidence-based update of the RUCAM, designed to give clinicians a framework for assessing DILI likelihood based on iterative testing of cases from the US Drug-Induced Liver Injury Network (DILIN) and the Spanish DILI Registry. While the ability to approximate expert opinion is quite good (AUCs 0.85–0.95), the RECAM should never be used as a standalone diagnostic. It is not a substitute for good clinical judgement. Specific limitations: • Designed for acute liver injury — rule out non-liver sources first. • Designed for idiosyncratic drug injuries, not direct hepatotoxins like acetaminophen. • Not designed to weigh one medication against another — score individually. • Built using medication DILI cases, not herbal/dietary supplements (use with caution for HDS). • Based on DILIN/Spanish Registries requiring transaminases ≥ 5× ULN. • Not designed for pre-market clinical trials or drug development.