Scientific Opportunities and Public Needs Improving Priority Setting and Public Input at the National Institutes of Health (1998) / Chapter Skim
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Criteria for Priority Setting
Criteria for Priority Setting
Pages 29-42
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From page 29... ...
They are also affected by health emergencies and epidemics, demographic trends affecting health, such as the aging of the population or changing patterns of tobacco and alcohol use, and new opportunities in science stemming from research advances or better research instruments. The criteria that guide these choices are essential for public understanding of NIH's activities and for ensuring adequate levels of public support for its mission and budget.
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From page 30... ...
Some legislators believe that the distribution of NIH funding does not adequately reflect the number of citizens affected by various diseases or the costs of various diseases to society. Advocates for individuals with various diseases tell Congress that NIH is neglecting research on their focal disease relative to the levels of research on other diseases.
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From page 31... ...
In 1995, at the request of Congress, NIH published a report with a table listing the burdens and costs of 66 diseases and conditions, including the 15 leading causes of death, and the amount of research funding that NIH was devoting to each. The data in that report and a later edition with more recent data
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From page 32... ...
," but "funding according to the economic cost of illness would under-fund diseases that result in short illness and rapid death (this choice would result in a great deal of funding for Alzheimer's disease and muscular dystrophy and little, or none, for sudden infant death syndrome or certain types of cancer)
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From page 33... ...
Indeed, although the Office of Financial Management has provided standard definitions for approximately 30 of the approximately 250 categories for which it compiles data reported by the institutes, it does not have the resources to ensure consistency and quality (the Office of Financial Management staff levels have been cut by two-thirds in recent years)
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From page 34... ...
. The director of the Center for Scientific Review recently appointed a blue ribbon external panel to address the aspect of peer review that most affects overall priority setting among study sections: the NIH practice of "percentiling," that is, funding the same percentage of proposals in each study section, which means that each section has a certain claim on funding.
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From page 35... ...
CRITERIA FOR PRIORITY SETTING 35 advance and scientific fields become obsolete and new ones emerge- then the allocation of the majority of NIH's funding that goes through the Center for Scientific Review is adversely affected. The new blue ribbon panel was directed explicitly to address this problem and recommend ways to update and to keep updated the study section structure.
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From page 36... ...
NIH has well-established and elaborate procedures, described in Chapter 3, for assessing scientific merit in priority setting beginning with the expertise of its own staff and strongly supplemented by formal and ad hoc mechanisms for receiving advice from outside experts. The committee wants to ensure that, in NIH's decision making on programs and funding of research, NIH has adequate procedures to ensure scientific innovation and to foster support for high-risk research with high payoffs if it is successful, interdisciplinary research that crosses program and study group lines, and unconventional but promising research approaches.
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From page 37... ...
This approach would leave those suffering now with no benefit from what knowledge is available, and it would not create the needed bridges from the laboratory to the real world, nor would it allow basic research to be informed systematically by clinical experience. Although NIH should, and does, invest in the full range of research approaches (e.g., basic, translational, clinical, epidemiologic, and behavioral research)
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From page 38... ...
To this end, the NIH's budget supports research training, acquisition of equipment and instruments, some limited construction projects, and grantee institutions' costs of enabling the research programs (National Institutes of Health, 1997b:4~. Finally, NIH must invest in the long-term integrity of the health research enterprise, not just the costs of current research projects.
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From page 39... ...
, and other relevant factors. Some institutes conduct regular analyses of disease rates both to adjust future research agendas to changing trends and to assess the impacts of past research advances.
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From page 40... ...
Users of the data should know that such calculations reflect the best estimates of total NIH spending in particular areas and that fundamental science is essential to discovering the etiology and progression of disease and other basic knowledge needed to develop improved means of diagnosis, improved prevention efforts, and improved treatments. In making this recommendation, the committee is mindful of the limits on the use of such data in research priority setting.
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From page 41... ...
The need for additional resources for priority setting is addressed to Congress in Recommendation 12, which addresses current congressional limitations on research management and support budgets.
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