Are American Clinical Research Companies or laboratories doing analysis for clinical trials required to use relational databases or non-relational databases or Relational Database Management Systems to store and documen data clinical trial data per Food and Drug Administration regulations? The advantages of a database include logging who logged in, and logging intruders/IP addresses, user control, access control, limiting people reading, blinding investigators. An Excel spreadsheet has to be re-formatted by click and drag every time to achieve blinding, and has no access control.
No laws to regulate how companies store data or report data leads to chaos. Do bureaucrats dislike chaos? There'd be no control over whether spreadsheets by hand, Excel spreadsheets, of complicated MongoDB databases are used. I am not sure whether FDA receives raw-data, but FDA would have a diversity of file formats including scanned notebooks, Excel files, and database files.