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This study was supported by a grant from the Japan Agency for Medical Research and Develop-ment (AMED) under Grant Number 19lk1903002 h0002.Author contributionsYN and RU have designed this study as a whole and written this manuscript. SN has contributed to statistical analyses. YN, RU, and SS have contrib-uted to data collection. All authors have contrib-uted, provide advice on the interpretation of the results, and approved the final manuscript.Conflicts of interest statementThere are no conflicts of interest to declare. 1) Ministry of Health, Labour and Welfare. About publi-cation of business report of core clinical research hospitals [Internet] [cited 7 Aug 2021]. Available from: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/ 0000165585.html. (in Japanese). 2) Ueda R, Nishizaki Y, Homma Y, et al: Importance of quality assessment in clinical research in Japan. Front Pharmacol, 2019; 10: 1228. 3) Ministry of Health, Labour and Welfare. About publi-cation of the Clinical Research Act [Internet] [cited 7 Aug 2021]. Available from: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000163417.html. (in Japa-nese). 4) Ministry of Health, Labour and Welfare. About publi-cation of jRCT (Japan Registry of Clinical Trials) [Internet] [cited 7 Aug 2021]. Available from: https://jrct.niph.go.jp (in Japanese). 5) Ueda K, Uemura N, Matsuyama K, et al: Performance index for types of clinical research support service providers for academic research organizations in Japan: a cross-sectional survey. Clin Transl Sci, 2021; 14: 745-55.415FundingReferences