# Epistemic Care & Metadata Completeness

In metadata quality assessment, does the completeness of African trial registrations on ClinicalTrials.gov indicate higher or lower administrative care than global averages? This audit evaluated optional reporting fields including outcomes, oversight details, and data-sharing plans for 23,873 African trials versus global comparators through March 2026. Investigators reported a metadata completeness index as the primary estimand for registration quality. African trials surprisingly exceeded the European average on metadata completeness, scoring an estimated sixty percent versus fifty-four percent on a composite index of optional field completion. This hidden rigour is likely driven by the strict reporting requirements of international sponsors and regulatory agencies that fund the majority of African research. However, completeness at registration did not translate to results reporting: only 58% of trials reached completion and an estimated thirty percent of those never posted results. These findings reveal a paradox where registration quality exceeds results transparency. Interpretation is limited by binary presence-absence scoring of metadata fields.

## References

1. Alemayehu C, et al. "Behind the mask of the African clinical trials landscape." Trials. 2018;19:519.
2. Drain PK, et al. "Global migration of clinical trials." Nat Rev Drug Discov. 2018;17:765-766.

## Note Block

- Type: research
- App: https://mahmood726-cyber.github.io/africa-e156-students/health-disease/dashboards/epistemic-care.html
- Code: https://github.com/mahmood726-cyber/africa-e156-students/blob/master/health-disease/code/epistemic-care.py
- Data: ClinicalTrials.gov API v2
- Date: 2026-04-05