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The National Institutes of Health provided $362 million in grants for clinical trials that enrolled at least 41,000 children over a recent three-year period — but many results were never published, a worrisome sign of a lack of transparency that can lead to wasted research funding, a new analysis found.

Specifically, just under two-thirds of the 354 trials studied were registered in advance with ClinicalTrials.gov, the federal database, and just 13% of finished trials were registered within 12 months of completion, according to the analysis, which was published in JAMA. The researchers also estimated that there was just a 54% likelihood  results would be published four years after grants were completed.

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The analysis comes amid increased scrutiny of clinical trial registration and reporting, a contentious issue that has plagued drugmakers, universities, and government agencies for years. Without access to published results, critics say it can be impossible for independent researchers to verify findings that can lead to improved treatments, better health care, and lower costs.

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