Paper
Raw sponsor league tables reward size. Adjusted sponsor watchlists ask who still looks worse than expected after visible study mix is held more constant.
Which named CT.gov sponsors remain worst once hiddenness is read as adjusted excess stock rather than raw rate alone? We analysed 249,507 eligible older closed interventional studies from the March 29, 2026 full-registry snapshot. We reused the study-mix-adjusted no-results and ghost models, then ranked sponsors with at least 100 studies by observed-versus-expected excess, black-box stock, overdue depth, and strict-core carryover. Assistance Publique - Hopitaux de Paris carried the largest adjusted excess no-results stock at 265 studies, followed by Sanofi at 197 and Cairo University at 164. Sanofi also showed 219 excess ghost protocols, while the strict U.S.-nexus core was led by National Cancer Institute at 361 missing-results studies. The sponsor backlog therefore does not collapse into one sector, but major industrial and hospital systems remain prominent repeat offenders across the international registry and its strict-core subset. These watchlists use registry-visible sponsorship and adjusted excess estimates, not audited legal responsibility, ultimate funder structure, or causally attributable silence.