The FDA approved 55 new drugs last year, emphasizing the importance of selecting appropriate clinical outcome assessments (COAs) in drug development. COAs are crucial for collecting patient data and securing regulatory approval, ensuring outcomes are meaningful to patients. Effective COAs must be relevant, psychometrically sound, and meet regulatory standards. Poor COA selection risks misleading results, regulatory delays, and patient burden. Pearson assessments, used in successful drug development for conditions like schizophrenia and spinal muscular atrophy, highlight the integral role of well-validated COAs in advancing drug development and securing approval.