NYT: Why the medical research grant system needs a revamp

Aaron E. Carroll, MD, associate dean for research mentoring at the Indiana University School of Medicine in Indianapolis and a New York Times contributor, wrote in a recent op-ed the National Institutes of Health's medical research grant system needs to be re-evaluated or risk losing the novel contributions of many researchers.

Dr. Carroll said the goal of the NIH's grant system is to spur innovation and foster research careers. However, he said its current model may be failing. According to a 2015 study published in the journal JAMA, research funding increased 0.8 percent year to year between 2004 and 2012, indicating the NIH's funding does not go as far as it used to.

Some experts also suggest the current grant system cannot distinguish between grants that are funded and those that did not receive financial support — the system's very purpose. A second study, published earlier this year in the Proceedings of the National Academy of Sciences of the United States of America, examined how a select group of researchers graded 25 proposals that all received NIH funding.

Experimenters recruited researchers to serve in mock study sections, just as the NIH does, to review the 25 grant applications and score the proposals as though they were up for funding consideration. Researchers found the intraclass correlation — a statistic that refers to how much the participants agreed with one another — was zero for the scores assigned, indicating none of the participants agreed on the quality of any of the 25 applications.

According to Dr. Carroll, the current grant system favors low-risk research and experienced researchers over newer individuals, as the NIH wouldn't want to defend null findings. Experienced researchers, he wrote, also have name recognition and know how to work the system in their favor.

Dr. Carroll also acknowledged the gender and racial biases inherent in the NIH's current grant funding system, noting the system "is not blinded, and many studies have shown that even after controlling for other factors, the ways in which grants are discussed, scored and funded can favor men over women, and whites over minorities."

"If researchers are getting into the top 10 percent more than others based on such factors, especially with less and less money available, many great proposals — and many great researchers — are being sidelined inappropriately," Dr. Carroll wrote. "We may be missing out on a lot of excellent, and perhaps novel, work that can't break into the top 10 percent because of structural problems. … The current granting system doesn't just fund the researchers of today — it also steers the careers of tomorrow. Should it fail, the repercussions will be felt for decades."

To access Dr. Carroll's full op-ed, click here.

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