Evidence-Based Medicine

Research Appraisals

Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.

Showing 4 appraisals

Randomised Controlled TrialEvidence: Weak
45CEBM

Journal of chemical information and modeling

Reinforcement Learning-Driven Multiproperty Optimization in Molecular Design Using Multicontext Transcriptome Data

Drug discovery inherently involves multiparameter optimization in the molecular design because drug candidate molecules must meet diverse properties such as bioactivity, synthesizability, and pharmacokinetic properties. This optimization has traditionally relied on iterative manual design and experimental testing, which are labor-intensive and time-consuming. There is therefore a strong incentive to develop computational methods that efficiently design drug-like molecules with multiple favorable properties using chemical and biological data on therapeutic targets. This study proposes a novel computational method for multiproperty optimization in the molecular structure design of bioactive molecules using multicontext (i.e., chemically and genetically perturbed) transcriptome data on human cells. We integrate a molecular generative model conditioned on a transcriptome profile observed with the target gene knockdown or overexpression into a reinforcement learning framework, enabling simultaneous optimization of a quantitative estimate of drug-likeness, synthetic accessibility score, and water/octanol partition coefficient, while accounting for system-level biological effects on a therapeutic target. Using comprehensive benchmarking against established baselines and rigorous validation across multiple metrics, we demonstrate that the proposed method consistently yields molecules with more favorable drug-like characteristics than existing methods. This proposed method can help achieve more efficient identification of novel drug candidates.

29 July 2026

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otherEvidence: Weak
45CEBM

Biomacromolecules

Challenges and Vision for Standardization of Biopolymer Data Sets for Machine Learning

Machine learning (ML) is transforming materials research, yet potential for biopolymer discovery remains constrained by fragmented data and nonstandardized reporting. Biopolymers differ significantly from synthetic polymers, requiring specialized approaches to represent their biosynthetic origins, hierarchical structures, and application-specific metrics. In this Perspective, we identify three core challenges limiting biopolymer representation: information encoding, data quality, and data sharing. We describe the most pressing issues and propose commensurate approaches to address each key challenge. Recommendations include the design and adoption of biopolymer-specific fingerprinting and representation frameworks, development of hybrid human-large language model (LLM) data extraction strategies, and expanding Findable, Accessible, Interoperable, Reusable (FAIR)-compliant repositories. We propose a robust foundation to define interoperable, high-quality data sets that capture the full context of biopolymer materials. Standardized metadata, shared ontologies, and community-driven infrastructure would enable scalable, reproducible workflows and accelerate the ML-driven development of biopolymers.

14 July 2026

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otherEvidence: Strong
85CEBM

Journal of chemical theory and computation

MolSculptor: An Adaptive Diffusion-Evolution Framework Enabling Generative Drug Design for Multitarget Affinity and Selectivity

The rational design of molecules with tailored activity/selectivity across multiple protein targets is crucial for developing therapies for complex diseases like cancer, yet it remains a formidable challenge. While deep generative models show immense promise, their application to these tasks faces fundamental challenges, as they struggle to incorporate the structural information on multiple distinct protein pockets and require vast multitarget data sets or specialized expert knowledge that are rarely available. Here we introduce MolSculptor, an adaptive diffusion-evolution framework designed to generate inhibitors for any combination of on- and off-targets, circumventing the need for target-specific training data or prior expert knowledge. MolSculptor unifies both de novo design and lead optimization, provides a versatile workflow applicable to different stages of drug discovery, and allows for direct conditioning on key drug-like properties. It integrates a 3D-aware surrogate model to enable flexible guidance for any set of specified on- and off-targets. Furthermore, MolSculptor employs an active learning protocol to adaptively refine this guidance, ensuring high performance even in data-scarce scenarios. We demonstrate MolSculptor on a series of challenging multitarget and selective inhibitor design tasks, where it significantly outperforms state-of-the-art methods in generating high-quality candidates that satisfy all complex constraints. Notably, many of the generated molecules exhibit predicted affinity profiles superior to those of experimentally validated references. Using MolSculptor, we successfully designed and synthesized a novel and potent dual-target inhibitor for castration-resistant prostate cancer (CRPC), whose inhibitory activity was confirmed through wet-lab validation. MolSculptor provides a powerful and generalizable paradigm for designing ligands with complex, multitarget activity profiles, paving the way for data-efficient solutions to complex therapeutic problems.

27 May 2026

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otherEvidence: Moderate
85CEBM

Environmental science. Processes & impacts

Machine learning-driven QSAR models for the prediction of metabolic mechanisms and thyroid hormone-disrupting effects of emerging pollutants in the human body: a case study of bisphenol analogues

Research on theoretical prediction methods for elucidating the reaction mechanisms and thyroid hormone-disrupting effects of emerging pollutants in the human body faces significant challenges. The application of in silico methods utilizing machine learning is increasingly recognized as an effective strategy to determine the mechanisms of reactions catalyzed by human cytochrome P450 enzymes (CYPs) and to predict the adverse effects of emerging pollutants. Bisphenol analogues (BPs) represent one of the most important endocrine disruptors. These compounds can cause serious effects on the ecological environment and human health. Herein, density functional theory (DFT) calculations was employed to investigate the reaction mechanisms of the O-addition and H-abstraction of 20 BPs by human CYPs. A machine-learning-integrated quantitative structure-activity relationship (ML-QSAR) framework was established to predict the energy barriers of three types of reactions. Moreover, binding affinities were calculated between BPs (including their metabolites) and TRβ-LBD to evaluate their thyroid hormone-disrupting effects. The binding affinity data of BPs to TRβ-LBD were used as a training set to develop a ML-QSAR model for efficient prediction of potentially hazardous BPs. A ML-QSAR model with an R2 of 0.869 was established to predict their thyroid hormone-disrupting effects. The study enhances our understanding of CYP catalytic mechanisms involving BPs and provides a reference for the future design of environmentally friendly BPs. The predictive model developed for thyroid hormone-disrupting effects can aid in identifying the adverse effects of emerging BPs, supporting more effective management of toxic compounds.

4 May 2026

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