CT.gov U.S. Versus Global Gap
2026-03-29 | full-registry ct.gov audit | plots, figures, and e156 bundle
Series
Geography Bucket Project

Does U.S. participation make older CT.gov studies more visible?

A standalone public project on U.S. versus global visibility, showing that cross-border studies are markedly cleaner than domestic-only or no-U.S. portfolios in older CT.gov records.

Mixed 30.2%
US only 55.8%
No US 88.7%
No country 80.9%

Project

This page pushes the geography work beyond simple country counts. The relevant split is whether a study is U.S. only, genuinely cross-border, entirely outside the U.S., or missing named-country detail altogether.

Mixed U.S.-global studies are the cleanest geography bucket in the wave, while no-U.S. portfolios sit in a far quieter registry zone.

Project readout

A standalone E156 project on how U.S.-only, cross-border, and non-U.S. geography buckets sharply separate older-study visibility on CT.gov.

Mixed no results
30.2%
US + non-US bucket
US-only no results
55.8%
Domestic-only studies
No-US no results
88.7%
No recorded US location
Mixed visible
46.3%
Results plus publication
Geography buckets
GEOGRAPHY BUCKETS2-year no-results rate by U.S./global geography bucketUS only55.8%US + non-US30.2%No US88.7%No country80.9%
Cross-border studies are the clear outlier on the cleaner side of the registry.
The gap is too large to dismiss as a minor location-footprint artifact.
Read Across Projects

Across The Series

The split projects are meant to be read together because each isolates a different dimension of registry opacity rather than forcing every question into one leaderboard.

Industry
CT.gov Industry Disclosure Gap

Industry-focused missing-results stock, sponsor backlogs, and structural sparsity inside CT.gov.

Sponsor Classes
CT.gov Sponsor-Class Hiddenness

Sponsor-class comparisons on rate, stock, and structural hiddenness rather than one flattened ranking.

Phases
CT.gov Phase Reporting Gap

Phase-by-phase disclosure gaps showing how silence changes along the development pathway.

Structural
CT.gov Structural Missingness

Field-level missingness across publication links, IPD statements, descriptions, and locations.

Visibility
CT.gov Evidence Visibility Gap

Results-plus-publication visibility states showing how many older trials are fully visible, partly visible, or ghosted.

Cohorts
CT.gov Completion Cohort Debt

Completion-era reporting debt showing how older eligible cohorts drift on no-results and ghost-protocol rates.

Conditions
CT.gov Condition Hiddenness Map

Keyword-classified therapeutic-area hiddenness mapping across common condition families.

Concentration
CT.gov Sponsor Backlog Concentration

Concentration and inequality analysis showing how much unresolved stock sits inside a thin sponsor slice.

Rule Eras
CT.gov Rule-Era Reporting Gap

Policy-era comparisons across pre-FDAAA, FDAAA, and later CT.gov completion cohorts.

PubMed Audit
CT.gov Publication Undercount Audit

Sample-based external PubMed NCT audit testing how often CT.gov no-link records hide an external paper trail.

Oncology
CT.gov Oncology Hiddenness

Oncology-specific CT.gov hiddenness showing where cancer-trial stock, phases, and sponsors still go quiet.

Cardiovascular
CT.gov Cardiovascular Hiddenness

Cardiovascular CT.gov hiddenness showing how heart and vascular studies remain quiet across major phases and sponsors.

Metabolic
CT.gov Metabolic Hiddenness

Metabolic CT.gov hiddenness across obesity, diabetes, and related trial portfolios with large late-phase and NA stock.

Size
CT.gov Enrollment-Size Gap

Enrollment-size gradients showing how older small trials remain much quieter than larger registered studies.

Geography
CT.gov Geography-Scale Visibility

Site and country footprint analysis showing how larger trial geographies map onto much better public visibility.

Purpose
CT.gov Design-Purpose Hiddenness

Primary-purpose and allocation analysis showing which trial intents remain most obscured on CT.gov.

Delay
CT.gov Completion-Delay Debt

Registration-to-completion delay analysis showing short-cycle studies carry the heaviest reporting debt.

Architecture
CT.gov Trial-Architecture Gap

Arm-count and intervention-count analysis showing simpler trial architectures are often the quietest.

Interventions
CT.gov Intervention-Type Gap

Intervention-family analysis showing which declared treatment modalities remain quietest on older CT.gov records.

Countries
CT.gov Country Reporting Map

Named-country visibility analysis showing large geographic divides in older CT.gov reporting debt.

Stopped
CT.gov Stopped-Trial Disclosure Gap

Final-status analysis showing how withdrawn, suspended, and terminated studies remain structurally quieter than completed trials.

Outcomes
CT.gov Outcome-Density Gap

Outcome-count and outcome-description analysis showing sparse protocols are often the quietest CT.gov segment.

Actual Fields
CT.gov Actual-Field Discipline

Closed-study actual-field analysis showing missing actual dates and counts are a strong warning sign for opacity.

Modality Sponsors
CT.gov Modality Sponsor Repeaters

Intervention-family sponsor audit showing that repeat offenders change sharply once modality is held fixed.

Country x Condition
CT.gov Country-Condition Hiddenness

Country-by-condition splits showing how disease-specific visibility changes once specific national footprints are named.

Disease Geography
CT.gov Disease Geography Gap

Disease-family geography buckets showing how oncology, cardiovascular, and metabolic studies diverge by U.S. participation.

Condition Sponsors
CT.gov Condition Sponsor Repeaters

Condition-family sponsor audit showing who carries the biggest hiddenness stock within oncology, cardiovascular, and metabolic studies.