Structure

Physi-Chem Properties

Molecular Weight:  392.22
Volume:  399.674
LogP:  3.431
LogD:  2.055
LogS:  -4.273
# Rotatable Bonds:  2
TPSA:  74.36
# H-Bond Aceptor:  6
# H-Bond Donor:  0
# Rings:  4
# Heavy Atoms:  6

MedChem Properties

QED Drug-Likeness Score:  0.386
Synthetic Accessibility Score:  6.2
Fsp3:  0.818
Lipinski Rule-of-5:  Accepted
Pfizer Rule:  Rejected
GSK Rule:  Accepted
BMS Rule:  2
Golden Triangle Rule:  Accepted
Chelating Alert:  0
PAINS Alert:  0

ADMET Properties (ADMETlab2.0)

ADMET: Absorption

Caco-2 Permeability:  -4.844
MDCK Permeability:  3.016508708242327e-05
Pgp-inhibitor:  0.996
Pgp-substrate:  0.0
Human Intestinal Absorption (HIA):  0.003
20% Bioavailability (F20%):  0.786
30% Bioavailability (F30%):  0.607

ADMET: Distribution

Blood-Brain-Barrier Penetration (BBB):  0.059
Plasma Protein Binding (PPB):  81.45223236083984%
Volume Distribution (VD):  1.581
Pgp-substrate:  18.138330459594727%

ADMET: Metabolism

CYP1A2-inhibitor:  0.019
CYP1A2-substrate:  0.146
CYP2C19-inhibitor:  0.028
CYP2C19-substrate:  0.593
CYP2C9-inhibitor:  0.093
CYP2C9-substrate:  0.029
CYP2D6-inhibitor:  0.014
CYP2D6-substrate:  0.289
CYP3A4-inhibitor:  0.58
CYP3A4-substrate:  0.318

ADMET: Excretion

Clearance (CL):  3.607
Half-life (T1/2):  0.223

ADMET: Toxicity

hERG Blockers:  0.153
Human Hepatotoxicity (H-HT):  0.583
Drug-inuced Liver Injury (DILI):  0.86
AMES Toxicity:  0.268
Rat Oral Acute Toxicity:  0.051
Maximum Recommended Daily Dose:  0.424
Skin Sensitization:  0.959
Carcinogencity:  0.356
Eye Corrosion:  0.788
Eye Irritation:  0.457
Respiratory Toxicity:  0.96

Download Data

Data Type Select
General Info & Identifiers & Properties  
Structure MOL file  
Source Organisms  
Biological Activities  
Similar NPs/Drugs  

  Natural Product: NPC474472

Natural Product ID:  NPC474472
Common Name*:   SBHQTFJDBYTNNZ-HZFQQVEYSA-N
IUPAC Name:   n.a.
Synonyms:  
Standard InCHIKey:  SBHQTFJDBYTNNZ-HZFQQVEYSA-N
Standard InCHI:  InChI=1S/C22H32O6/c1-13-15-6-9-21(4,28-19(13)24)17-8-11-20(3,26-17)16(25-14(2)23)7-10-22(5)18(12-15)27-22/h15-18H,1,6-12H2,2-5H3/t15-,16+,17+,18-,20-,21-,22+/m1/s1
SMILES:  CC(=O)OC1CCC2(C(O2)CC3CCC(C4CCC1(O4)C)(OC(=O)C3=C)C)C
Synthetic Gene Cluster:   n.a.
ChEMBL Identifier:   CHEMBL469487
PubChem CID:   44560943
Chemical Classification**:  
  • CHEMONTID:0000000 [Organic compounds]
    • [CHEMONTID:0000261] Phenylpropanoids and polyketides
      • [CHEMONTID:0000147] Macrolides and analogues

*Note: the InCHIKey will be temporarily assigned as the "Common Name" if no IUPAC name or alternative short name is available.
**Note: the Chemical Classification was calculated by NPClassifier Version 1.5. Reference: PMID:34662515.

  Species Source

Organism ID Organism Name Taxonomy Level Family SuperKingdom Isolation Part Collection Location Collection Time Reference
NPO3821 Sinularia flexibilis Species Alcyoniidae Eukaryota n.a. chinese soft coral n.a. PMID[18553926]
NPO3821 Sinularia flexibilis Species Alcyoniidae Eukaryota n.a. n.a. n.a. PMID[30528697]
NPO3821 Sinularia flexibilis Species Alcyoniidae Eukaryota n.a. n.a. n.a. PMID[9644083]

☑ Note for Reference:
In addition to directly collecting NP source organism data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated them from below databases:
UNPD: Universal Natural Products Database [PMID: 23638153].
StreptomeDB: a database of streptomycetes natural products [PMID: 33051671].
TM-MC: a database of medicinal materials and chemical compounds in Northeast Asian traditional medicine [PMID: 26156871].
TCM@Taiwan: a Traditional Chinese Medicine database [PMID: 21253603].
TCMID: a Traditional Chinese Medicine database [PMID: 29106634].
TCMSP: The traditional Chinese medicine systems pharmacology database and analysis platform [PMID: 24735618].
HerDing: a herb recommendation system to treat diseases using genes and chemicals [PMID: 26980517].
MetaboLights: a metabolomics database [PMID: 27010336].
FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

  NP Quantity Composition/Concentration

Organism ID NP ID Organism Material Preparation Organism Part NP Quantity (Standard) NP Quantity (Minimum) NP Quantity (Maximum) Quantity Unit Reference

☑ Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP quantitative records for specific NP domains (e.g., NPS from foods or herbs) from domain-specific databases. These databases include:
DUKE: Dr. Duke's Phytochemical and Ethnobotanical Databases.
PHENOL EXPLORER: is the first comprehensive database on polyphenol content in foods [PMID: 24103452], its homepage can be accessed at here.
FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

  Biological Activity

Target ID Target Type Target Name Target Organism Activity Type Activity Relation Value Unit Reference
NPT20529 NON-MOLECULAR NON-PROTEIN TARGET n.a. IC50 > 10.0 ug.mL-1 PMID[542997]

☑ Note for Activity Records:
☉ The quantitative biological activities were primarily integrated from ChEMBL (Version-30) database and were also directly collected from PubMed literature. PubMed PMID was provided as the reference link for each activity record.

  Chemically structural similarity: I. Similar Active Natural Products in NPASS

Top-200 similar NPs were calculated against the active-NP-set (includes 4,3285 NPs with experimentally-derived bioactivity available in NPASS)

Similarity level is defined by Tanimoto coefficient (Tc) between two molecules. Tc lies between [0, 1] where '1' indicates the highest similarity. What is Tanimoto coefficient

●  The left chart: Distribution of similarity level between NPC474472 and all remaining natural products in the NPASS database.
●  The right table: Most similar natural products (Tc>=0.56 or Top200).

Similarity Score Similarity Level Natural Product ID
1.0 High Similarity NPC257358
0.961 High Similarity NPC474981
0.9259 High Similarity NPC304509
0.9259 High Similarity NPC149725
0.9259 High Similarity NPC47958
0.9146 High Similarity NPC474762
0.9146 High Similarity NPC476015
0.9146 High Similarity NPC475019
0.9146 High Similarity NPC474949
0.9024 High Similarity NPC329749
0.881 High Similarity NPC5130
0.881 High Similarity NPC231889
0.8721 High Similarity NPC475748
0.8675 High Similarity NPC474780
0.8605 High Similarity NPC474951
0.8605 High Similarity NPC151770
0.8554 High Similarity NPC272814
0.8488 Intermediate Similarity NPC58219
0.8488 Intermediate Similarity NPC281516
0.8488 Intermediate Similarity NPC177629
0.8471 Intermediate Similarity NPC470242
0.8452 Intermediate Similarity NPC470238
0.8452 Intermediate Similarity NPC151176
0.8452 Intermediate Similarity NPC475963
0.8452 Intermediate Similarity NPC3464
0.8452 Intermediate Similarity NPC138647
0.8391 Intermediate Similarity NPC92974
0.8391 Intermediate Similarity NPC173926
0.8391 Intermediate Similarity NPC307411
0.8372 Intermediate Similarity NPC186148
0.8372 Intermediate Similarity NPC248602
0.8315 Intermediate Similarity NPC212486
0.8295 Intermediate Similarity NPC51004
0.8276 Intermediate Similarity NPC474471
0.8276 Intermediate Similarity NPC227379
0.8242 Intermediate Similarity NPC476315
0.8222 Intermediate Similarity NPC473316
0.8222 Intermediate Similarity NPC81386
0.8222 Intermediate Similarity NPC474035
0.8222 Intermediate Similarity NPC473330
0.8202 Intermediate Similarity NPC70251
0.8202 Intermediate Similarity NPC475881
0.8202 Intermediate Similarity NPC30515
0.8202 Intermediate Similarity NPC329952
0.8202 Intermediate Similarity NPC184463
0.8182 Intermediate Similarity NPC166919
0.8161 Intermediate Similarity NPC475703
0.8161 Intermediate Similarity NPC270270
0.814 Intermediate Similarity NPC50362
0.814 Intermediate Similarity NPC38468
0.814 Intermediate Similarity NPC99395
0.814 Intermediate Similarity NPC197903
0.814 Intermediate Similarity NPC319795
0.8132 Intermediate Similarity NPC270013
0.8132 Intermediate Similarity NPC14961
0.8132 Intermediate Similarity NPC475900
0.8118 Intermediate Similarity NPC170377
0.8111 Intermediate Similarity NPC476300
0.809 Intermediate Similarity NPC469718
0.809 Intermediate Similarity NPC62815
0.809 Intermediate Similarity NPC476004
0.809 Intermediate Similarity NPC329857
0.809 Intermediate Similarity NPC474761
0.8068 Intermediate Similarity NPC202672
0.8068 Intermediate Similarity NPC153805
0.8046 Intermediate Similarity NPC469676
0.8046 Intermediate Similarity NPC50637
0.8022 Intermediate Similarity NPC471147
0.8 Intermediate Similarity NPC12172
0.8 Intermediate Similarity NPC208886
0.8 Intermediate Similarity NPC246076
0.8 Intermediate Similarity NPC20713
0.7979 Intermediate Similarity NPC186861
0.7978 Intermediate Similarity NPC472872
0.7955 Intermediate Similarity NPC118601
0.7955 Intermediate Similarity NPC190753
0.7935 Intermediate Similarity NPC475659
0.7935 Intermediate Similarity NPC36954
0.7935 Intermediate Similarity NPC476053
0.7931 Intermediate Similarity NPC474547
0.7912 Intermediate Similarity NPC81419
0.7912 Intermediate Similarity NPC475912
0.7912 Intermediate Similarity NPC179746
0.7907 Intermediate Similarity NPC11620
0.7907 Intermediate Similarity NPC128429
0.7889 Intermediate Similarity NPC49342
0.7889 Intermediate Similarity NPC312042
0.7889 Intermediate Similarity NPC251385
0.7882 Intermediate Similarity NPC141810
0.7882 Intermediate Similarity NPC47635
0.7872 Intermediate Similarity NPC279561
0.7872 Intermediate Similarity NPC474213
0.7865 Intermediate Similarity NPC178875
0.7857 Intermediate Similarity NPC617
0.7849 Intermediate Similarity NPC31645
0.7849 Intermediate Similarity NPC76862
0.7849 Intermediate Similarity NPC39859
0.7849 Intermediate Similarity NPC158416
0.7849 Intermediate Similarity NPC476009
0.7849 Intermediate Similarity NPC470883
0.7849 Intermediate Similarity NPC473859
0.7841 Intermediate Similarity NPC469626
0.7841 Intermediate Similarity NPC475491
0.7826 Intermediate Similarity NPC476267
0.7826 Intermediate Similarity NPC57405
0.7826 Intermediate Similarity NPC190294
0.7826 Intermediate Similarity NPC140543
0.7826 Intermediate Similarity NPC476722
0.7826 Intermediate Similarity NPC303942
0.7816 Intermediate Similarity NPC72464
0.7789 Intermediate Similarity NPC288876
0.7789 Intermediate Similarity NPC471381
0.7766 Intermediate Similarity NPC328562
0.7766 Intermediate Similarity NPC323421
0.7766 Intermediate Similarity NPC471150
0.7765 Intermediate Similarity NPC474510
0.7742 Intermediate Similarity NPC474947
0.7727 Intermediate Similarity NPC235792
0.7727 Intermediate Similarity NPC137033
0.7717 Intermediate Similarity NPC472874
0.7708 Intermediate Similarity NPC201718
0.7708 Intermediate Similarity NPC264477
0.7708 Intermediate Similarity NPC477511
0.7708 Intermediate Similarity NPC476270
0.7701 Intermediate Similarity NPC54468
0.7701 Intermediate Similarity NPC170286
0.7692 Intermediate Similarity NPC206614
0.7692 Intermediate Similarity NPC474323
0.7684 Intermediate Similarity NPC208233
0.7684 Intermediate Similarity NPC473326
0.7674 Intermediate Similarity NPC207188
0.7667 Intermediate Similarity NPC224652
0.766 Intermediate Similarity NPC476275
0.766 Intermediate Similarity NPC279621
0.766 Intermediate Similarity NPC17585
0.766 Intermediate Similarity NPC35498
0.7653 Intermediate Similarity NPC474741
0.764 Intermediate Similarity NPC162071
0.764 Intermediate Similarity NPC474045
0.764 Intermediate Similarity NPC304558
0.764 Intermediate Similarity NPC284902
0.764 Intermediate Similarity NPC261253
0.764 Intermediate Similarity NPC64153
0.764 Intermediate Similarity NPC122502
0.7634 Intermediate Similarity NPC66581
0.7619 Intermediate Similarity NPC470240
0.7619 Intermediate Similarity NPC476794
0.7614 Intermediate Similarity NPC9868
0.7609 Intermediate Similarity NPC165180
0.7609 Intermediate Similarity NPC286341
0.7609 Intermediate Similarity NPC155215
0.7609 Intermediate Similarity NPC191339
0.759 Intermediate Similarity NPC471491
0.7582 Intermediate Similarity NPC4986
0.7582 Intermediate Similarity NPC283409
0.7582 Intermediate Similarity NPC474032
0.7579 Intermediate Similarity NPC471140
0.7579 Intermediate Similarity NPC474921
0.7576 Intermediate Similarity NPC243998
0.7576 Intermediate Similarity NPC223450
0.7576 Intermediate Similarity NPC54737
0.7556 Intermediate Similarity NPC24728
0.7553 Intermediate Similarity NPC167893
0.7553 Intermediate Similarity NPC163228
0.7553 Intermediate Similarity NPC224689
0.7529 Intermediate Similarity NPC264610
0.7527 Intermediate Similarity NPC258216
0.7527 Intermediate Similarity NPC135776
0.7527 Intermediate Similarity NPC228451
0.7527 Intermediate Similarity NPC125674
0.7527 Intermediate Similarity NPC475838
0.7527 Intermediate Similarity NPC153590
0.7526 Intermediate Similarity NPC15993
0.75 Intermediate Similarity NPC80875
0.75 Intermediate Similarity NPC65359
0.75 Intermediate Similarity NPC318468
0.75 Intermediate Similarity NPC45125
0.75 Intermediate Similarity NPC475842
0.7475 Intermediate Similarity NPC477510
0.7475 Intermediate Similarity NPC471143
0.7473 Intermediate Similarity NPC217983
0.7473 Intermediate Similarity NPC476704
0.7473 Intermediate Similarity NPC79549
0.7473 Intermediate Similarity NPC471149
0.7473 Intermediate Similarity NPC207114
0.7471 Intermediate Similarity NPC301477
0.7471 Intermediate Similarity NPC25684
0.7471 Intermediate Similarity NPC281949
0.7449 Intermediate Similarity NPC320019
0.7449 Intermediate Similarity NPC474747
0.7449 Intermediate Similarity NPC324017
0.7447 Intermediate Similarity NPC474247
0.7447 Intermediate Similarity NPC476716
0.7444 Intermediate Similarity NPC238593
0.7444 Intermediate Similarity NPC204048
0.7444 Intermediate Similarity NPC164393
0.7442 Intermediate Similarity NPC80999
0.7442 Intermediate Similarity NPC19841
0.7423 Intermediate Similarity NPC477512
0.7419 Intermediate Similarity NPC470373

  Chemically structural similarity: II. Similar Clinical/Approved Drugs

Similarity level is defined by Tanimoto coefficient (Tc) between two molecules.

●  The left chart: Distribution of similarity level between NPC474472 and all drugs/candidates.
●  The right table: Most similar clinical/approved drugs (Tc>=0.56 or Top200).

Similarity Score Similarity Level Drug ID Developmental Stage
0.814 Intermediate Similarity NPD1733 Clinical (unspecified phase)
0.7582 Intermediate Similarity NPD1695 Approved
0.7312 Intermediate Similarity NPD46 Approved
0.7312 Intermediate Similarity NPD6698 Approved
0.699 Remote Similarity NPD7899 Clinical (unspecified phase)
0.6947 Remote Similarity NPD7838 Discovery
0.6792 Remote Similarity NPD6371 Approved
0.6701 Remote Similarity NPD7983 Approved
0.6667 Remote Similarity NPD1698 Clinical (unspecified phase)
0.6514 Remote Similarity NPD6053 Discontinued
0.6506 Remote Similarity NPD2685 Clinical (unspecified phase)
0.6452 Remote Similarity NPD4752 Clinical (unspecified phase)
0.6449 Remote Similarity NPD6686 Approved
0.6415 Remote Similarity NPD6008 Approved
0.6408 Remote Similarity NPD6648 Approved
0.6355 Remote Similarity NPD5954 Clinical (unspecified phase)
0.6346 Remote Similarity NPD5344 Discontinued
0.6311 Remote Similarity NPD8029 Clinical (unspecified phase)
0.6277 Remote Similarity NPD6435 Approved
0.6273 Remote Similarity NPD8413 Clinical (unspecified phase)
0.625 Remote Similarity NPD1694 Approved
0.6239 Remote Similarity NPD4061 Clinical (unspecified phase)
0.6182 Remote Similarity NPD5955 Clinical (unspecified phase)
0.6147 Remote Similarity NPD5345 Clinical (unspecified phase)
0.6139 Remote Similarity NPD5779 Approved
0.6139 Remote Similarity NPD5778 Approved
0.6105 Remote Similarity NPD5209 Approved
0.6064 Remote Similarity NPD5368 Approved
0.6044 Remote Similarity NPD8039 Approved
0.6042 Remote Similarity NPD7154 Phase 3
0.6018 Remote Similarity NPD8133 Approved
0.6 Remote Similarity NPD7638 Approved
0.596 Remote Similarity NPD4250 Approved
0.596 Remote Similarity NPD4251 Approved
0.5943 Remote Similarity NPD7639 Approved
0.5943 Remote Similarity NPD7640 Approved
0.5941 Remote Similarity NPD5785 Approved
0.5932 Remote Similarity NPD8513 Phase 3
0.5932 Remote Similarity NPD8516 Approved
0.5932 Remote Similarity NPD8515 Approved
0.5932 Remote Similarity NPD8268 Approved
0.5932 Remote Similarity NPD8266 Approved
0.5932 Remote Similarity NPD8269 Approved
0.5932 Remote Similarity NPD8517 Approved
0.5932 Remote Similarity NPD8267 Approved
0.5922 Remote Similarity NPD5282 Discontinued
0.5918 Remote Similarity NPD6082 Clinical (unspecified phase)
0.5877 Remote Similarity NPD4632 Approved
0.5876 Remote Similarity NPD5362 Discontinued
0.5868 Remote Similarity NPD7507 Approved
0.5862 Remote Similarity NPD7115 Discovery
0.5859 Remote Similarity NPD5786 Approved
0.5859 Remote Similarity NPD5330 Approved
0.5859 Remote Similarity NPD7146 Approved
0.5859 Remote Similarity NPD7521 Approved
0.5859 Remote Similarity NPD6409 Approved
0.5859 Remote Similarity NPD6684 Approved
0.5859 Remote Similarity NPD4249 Approved
0.5859 Remote Similarity NPD7334 Approved
0.5849 Remote Similarity NPD4225 Approved
0.5842 Remote Similarity NPD5764 Clinical (unspecified phase)
0.5842 Remote Similarity NPD6101 Approved
0.5833 Remote Similarity NPD1780 Approved
0.5833 Remote Similarity NPD7642 Approved
0.5833 Remote Similarity NPD7829 Approved
0.5833 Remote Similarity NPD7604 Phase 2
0.5833 Remote Similarity NPD7830 Approved
0.5833 Remote Similarity NPD1145 Discontinued
0.5833 Remote Similarity NPD1779 Approved
0.5833 Remote Similarity NPD5369 Approved
0.5814 Remote Similarity NPD7909 Approved
0.581 Remote Similarity NPD7839 Suspended
0.5789 Remote Similarity NPD8297 Approved
0.5785 Remote Similarity NPD7492 Approved
0.5758 Remote Similarity NPD5363 Approved
0.5747 Remote Similarity NPD7341 Phase 2
0.5743 Remote Similarity NPD7513 Clinical (unspecified phase)
0.5743 Remote Similarity NPD6903 Approved
0.5743 Remote Similarity NPD5737 Approved
0.5743 Remote Similarity NPD6672 Approved
0.5738 Remote Similarity NPD6616 Approved
0.5738 Remote Similarity NPD8273 Phase 1
0.5729 Remote Similarity NPD4820 Approved
0.5729 Remote Similarity NPD4822 Approved
0.5729 Remote Similarity NPD4819 Approved
0.5729 Remote Similarity NPD5790 Clinical (unspecified phase)
0.5729 Remote Similarity NPD4821 Approved
0.5728 Remote Similarity NPD6411 Approved
0.5728 Remote Similarity NPD8035 Phase 2
0.5728 Remote Similarity NPD5693 Phase 1
0.5728 Remote Similarity NPD8034 Phase 2
0.5726 Remote Similarity NPD7319 Approved
0.5726 Remote Similarity NPD6009 Approved
0.5714 Remote Similarity NPD6899 Approved
0.5714 Remote Similarity NPD6881 Approved
0.5714 Remote Similarity NPD6054 Approved
0.5714 Remote Similarity NPD6319 Approved
0.5714 Remote Similarity NPD6356 Clinical (unspecified phase)
0.57 Remote Similarity NPD6422 Discontinued
0.5691 Remote Similarity NPD7078 Approved
0.5691 Remote Similarity NPD8074 Phase 3
0.5684 Remote Similarity NPD5784 Clinical (unspecified phase)
0.5682 Remote Similarity NPD7331 Phase 2
0.5676 Remote Similarity NPD7128 Approved
0.5676 Remote Similarity NPD6402 Approved
0.5676 Remote Similarity NPD6675 Approved
0.5676 Remote Similarity NPD5739 Approved
0.5673 Remote Similarity NPD6399 Phase 3
0.5667 Remote Similarity NPD5983 Phase 2
0.5659 Remote Similarity NPD7966 Clinical (unspecified phase)
0.5645 Remote Similarity NPD7736 Approved
0.5644 Remote Similarity NPD3573 Approved
0.5635 Remote Similarity NPD7260 Phase 2
0.5625 Remote Similarity NPD5697 Approved
0.5625 Remote Similarity NPD6412 Phase 2
0.562 Remote Similarity NPD6370 Approved
0.5619 Remote Similarity NPD7901 Clinical (unspecified phase)
0.5619 Remote Similarity NPD7900 Approved
0.5614 Remote Similarity NPD7102 Approved
0.5614 Remote Similarity NPD7290 Approved
0.5614 Remote Similarity NPD6883 Approved
0.5612 Remote Similarity NPD4269 Approved
0.5612 Remote Similarity NPD4270 Approved
0.561 Remote Similarity NPD6336 Discontinued

  Bioactivity similarity: Similar Natural Products in NPASS

Bioactivity similarity was calculated based on bioactivity descriptors of compounds. The bioactivity descriptors were calculated by a recently developed AI algorithm Chemical Checker (CC) [Nature Biotechnology, 38:1087–1096, 2020; Nature Communications, 12:3932, 2021], which evaluated bioactivity similarities at five levels:
A: chemistry similarity;
B: biological targets similarity;
C: networks similarity;
D: cell-based bioactivity similarity;
E: similarity based on clinical data.

Those 5 categories of CC bioactivity descriptors were calculated and then subjected to manifold projection using UMAP algorithm, to project all NPs on a 2-Dimensional space. The current NP was highlighted with a small circle in the 2-D map. Below figures: left-to-right, A-to-E.

A: chemistry similarity
B: biological targets similarity
C: networks similarity
D: cell-based bioactivity similarity
E: similarity based on clinical data