Core Insights - Medpace Holdings, Inc. is under investigation for potential securities law claims due to discrepancies between public statements and internal data regarding its clinical-trial booking pipeline [1] - The company reported a Q4 2025 book-to-bill ratio of 1.04, significantly lower than its historical range of 1.10 to 1.25, indicating a concerning trend in business health [1] - Following the earnings report, Medpace shares dropped approximately 15.9%, primarily attributed to the bookings miss [1] Company Performance - Medpace reported Q4 2025 revenue of $708.5 million and GAAP EPS of $4.67, both exceeding consensus estimates [1] - The ending backlog as of December 31, 2025, was approximately $3 billion, reflecting a modest year-over-year growth of 4.3% [1] Industry Context - The book-to-bill ratio is a critical forward-looking indicator in the contract research organization (CRO) sector, with significant implications for valuation and investor expectations [1] - The CRO industry experienced record demand post-pandemic, making any decline in booking momentum particularly impactful for investor assessments of future growth [1]