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Preclinical development consists of a series of tests that ensure the safety and efficacy of a new therapeutic compound before it is tested in humans. There are four main phases to this process. First, safety pharmacology tests are conducted to ensure the drug does not produce any acutely harmful effects. These tests examine parameters such as bronchoconstriction, cardiac dysrhythmias, blood pressure changes, and ataxia. Next, preliminary toxicological testing is performed to determine the...
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Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
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Drugs, the chemical agents used in diagnosing, treating, or preventing diseases, undergo a four-phase process of development: pharmaceutic, pharmacokinetics, pharmacodynamics, and therapeutic.
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In vitro dissolution and drug release tests assess how quickly and how much of a drug is released from its dosage form into an aqueous medium under standardized laboratory conditions. These tests are essential tools in pharmaceutical development and quality assurance, offering insight into the drug's performance before clinical use.During formulation development, dissolution testing identifies incomplete or inconsistent drug release issues. It also supports decisions on selecting the optimal...
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Drug regulation encompasses the management of drug usage by evaluating its safety and efficacy through assessments conducted by regulatory authorities. Regrettably, the history of drug regulation is marred by several catastrophic events. One such incident is the Elixir Sulfanilamide tragedy, in which the toxic compound diethyl glycol was included in a sweet-tasting medication, leading to numerous fatalities. This event prompted the enactment of the Food, Drug, and Cosmetic Act in 1938. Under...
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Updated: Jan 7, 2026

Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
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Drug Development.

Sayaka Machizawa1, Gila Barbati1, Madison Soleil DeCapo1

  • 1Signant Health, Blue Bell, PA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary

Errors in the Mini-Mental State Examination (MMSE) administration and scoring are common in Alzheimer's disease clinical trials. Improving rater training and implementing data quality monitoring can enhance data accuracy.

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Area of Science:

  • Neurology
  • Clinical Trials
  • Cognitive Assessment

Background:

  • The Mini-Mental State Examination (MMSE) is a widely used cognitive assessment tool in clinical research.
  • Despite its prevalence, administration and scoring errors are frequently observed.
  • These errors arise from inconsistent guidelines, rater experience, and application of criteria.

Purpose of the Study:

  • To identify and explore common administration and scoring errors in the MMSE.
  • To investigate these errors among site raters in multinational Alzheimer's disease clinical trials.

Main Methods:

  • Central reviews of MMSE assessments from two multinational Phase 3 Alzheimer's disease trials were conducted.
  • Trained central reviewers analyzed audio and data from MMSE screenings, identifying errors using predefined flags.
  • Error frequencies were calculated based on consistent training and flag sets across studies.

Main Results:

  • Over 10,000 MMSE assessments were reviewed, with approximately 27% flagged for administration errors and 27% for scoring errors.
  • The most frequent errors included administration and scoring issues in Orientation to Place, and administration errors in Attention and Calculation, Orientation to Time, and Writing.
  • Detailed frequencies of these common errors are presented.

Conclusions:

  • The Mini-Mental State Examination (MMSE) exhibits common administration and scoring errors in clinical trials.
  • Non-standardized practices can introduce data variability, potentially impacting study outcomes.
  • Implementing robust data quality monitoring, central reviews, and enhanced rater training is crucial for improving data accuracy and reliability.