Upload
patrick89
View
211
Download
0
Tags:
Embed Size (px)
Citation preview
NIH Future DirectionsNIH Future Directions
Craig J. McClain, M.D., ProfessorCraig J. McClain, M.D., Professor
Division of Gastroenterology/HepatologyDivision of Gastroenterology/Hepatology
Departments of Medicine, Pharmacology and Departments of Medicine, Pharmacology and ToxicologyToxicology
University of Louisville University of Louisville
Louisville VA Medical Center Louisville VA Medical Center
ObjectivesObjectives
NIH FinancesNIH Finances
NIH trends, changesNIH trends, changes
Update on CTSAsUpdate on CTSAs
Challenges for UofL CTSA, LICTS Challenges for UofL CTSA, LICTS and U of L Researchand U of L Research
NIH Budget: What Is Really Happening?NIH Budget: What Is Really Happening?
Universities
Flat-line budget
Major NIH funding loss
“What we have here is a failure to communicate”
Cool Hand Luke
Politics & Economics: Law Shifts NIH Balance of Power Patient Groups Fear For Their Research As Funds Are Pooled By Bernard Wysocki Jr., The Wall Street Journal, Jan 31, 2007 Congress has strengthened Dr. [Elias Zerhouni]'s hand considerably. As part of a bill passed in December's lame-duck session, Dr. Zerhouni and his successors will be able to organize a "common fund" designed eventually to pool about 5% of the NIH's money. That is $1.5 billion a year at today's levels. The idea is to pour funding into research projects that cut across traditional biomedical fields and across multiple NIH fiefs. The new program addresses some of Congress's concerns that the NIH is big, slow and can't innovate.
1998 1999 2000 2001 2002 2003 2004 2005 2006 20070
5
10
15
20
25
30
35
NIH ($billions)
$ (Billions)
NIH Congressional AppropriationsNIH Congressional Appropriations
Doubling
00
1010
2020
3030
4040
5050
6060
7070
8080
UofL ($millions)UofL ($millions)
$ (M
illio
ns)
$ (M
illio
ns)
As Many New As Many New ApplicantsApplicants in the in the Last 2 yearsLast 2 years as during the previous 5 years! as during the previous 5 years!
≈≈
26583 - 21249
(2003) – (1999)Period of doubling
5334
31791 - 26583
(2005) – (2003)
5208
UofL/UK NIH FundingUofL/UK NIH Funding
0102030405060708090
NIH
Do
llars
Millions
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
UK
UofL
Source: NIH OER database
UofL Programs of DistinctionUofL Programs of Distinction
0 5 10 15 20
Neurosciences
Birth Defects
Oncology
Cardiovascular
Millions of Dollars ($)
2005
2000
Growth of R21 Applications Reviewed at CSR vs. Other ICs
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2001 2002 2003 2004 2005 2006
CSR Other
Growth of R01 Applications Reviewed at CSR vs. Other ICs
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2001 2002 2003 2004 2005 2006
CSR Other
Number of NIH Number of NIH KK Awards Awards
GOOD NEWS
1,500
2,000
2,500
3,000
3,500
4,000
4,500
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Fiscal Year
Nu
mb
er
NIH GoalNIH Goal
Fund training awardsFund training awards
Keep the pipeline openKeep the pipeline open
TEST – What is “correct” TEST – What is “correct” first grant?first grant?
36 year old new MD faculty 36 year old new MD faculty membermember–RO3RO3–R21R21–RO1RO1–K23K23–K12K12
NIH NIH Trends/InnovationsTrends/Innovations
Major Complaints About NIH Major Complaints About NIH Peer ReviewPeer Review
The process is too slowThe process is too slow
There are not enough senior/experienced reviewersThere are not enough senior/experienced reviewers
The process favors predictable research instead of The process favors predictable research instead of significant, innovative, or transformative researchsignificant, innovative, or transformative research
Clinical research may not fare as well as other Clinical research may not fare as well as other researchresearch
The time and effort required to write, submit, resubmit, The time and effort required to write, submit, resubmit, review and re-review is a heavy burden on applicants review and re-review is a heavy burden on applicants and reviewersand reviewers
Updated Oct. 4, 2006
Electronic SubmissionElectronic SubmissionTransition TimelineTransition Timeline
Electronic SubmissionElectronic SubmissionNew dates prevent “submission overload”New dates prevent “submission overload”Most submissions not on 1Most submissions not on 1stst of month of monthNIH contributes only about ½ of NIH contributes only about ½ of submissionssubmissionsFeb 5, 2007 – about 4,000 RO1sFeb 5, 2007 – about 4,000 RO1s82% error-free on 182% error-free on 1stst attempt attempteRA Commons record 19,283 logins on eRA Commons record 19,283 logins on Feb 5, 2007Feb 5, 2007
Shorter ApplicationShorter ApplicationProbably ~15 pagesProbably ~15 pages
Many other grants shorterMany other grants shorter– Canada, VA, DODCanada, VA, DOD
NIH Guide Survey on Shorter R01 ApplicationsNIH Guide Survey on Shorter R01 Applications
Responses Responses NumberNumber PercentPercent
For Shorter ApplicationsFor Shorter Applications 2,3572,357 74%74%
Against Shorter ApplicationsAgainst Shorter Applications 846846 26%26%
TotalTotal 3,2033,203 100%100%
Reviewer Crisis Reviewer Crisis
Far too many reviewers on study Far too many reviewers on study sectionssections
Too many ad hoc reviewersToo many ad hoc reviewers
Not enough “senior” reviewersNot enough “senior” reviewers
Almost 80,000 grants – lots of work!Almost 80,000 grants – lots of work!
~ 20,000 reviewers~ 20,000 reviewers
The First NIH The First NIH Study Section Study Section
19461946
The Last NIH The Last NIH Study Section Study Section
20062006
Smaller LargerOlder YoungerReviewed ~12 grants Review ~ 6 grants
Expanding Peer Review’s Expanding Peer Review’s PlatformsPlatforms
Electronic ReviewsElectronic Reviews
Telephone Enhanced DiscussionsTelephone Enhanced Discussions
Video Enhanced DiscussionsVideo Enhanced Discussions
Asynchronous Electronic DiscussionsAsynchronous Electronic Discussions
Study Sections
Our Goal: 10% of all reviews to be electronic in 2007
What It Looks Like: Video What It Looks Like: Video Enhanced DiscussionsEnhanced Discussions
What It Looks Like: What It Looks Like: Asynchronous Electronic DiscussionsAsynchronous Electronic Discussions
Shortened Review CycleShortened Review Cycle
NIH Pilot Study of New Investigator R01sNIH Pilot Study of New Investigator R01s
Who Benefits from Quick Review?Who Benefits from Quick Review?
- On “bubble” or close- On “bubble” or close
- Able to respond quickly with - Able to respond quickly with changes/new datachanges/new data
Only 13% in pilot study could do soOnly 13% in pilot study could do so
A Proposal for Deep Innovation A Proposal for Deep Innovation GrantsGrants
Short, 5-8 pagesShort, 5-8 pages
Focus on people, not payoffFocus on people, not payoff
Relevance separated from reviewRelevance separated from review
Ranking, not scoringRanking, not scoring
We’re not good predicting big advancesWe’re not good predicting big advances
Multiple PI InitiativeMultiple PI InitiativePrincipal Investigators (PIs) sometimes work in Principal Investigators (PIs) sometimes work in teamsteamsMany projects dependent on collaborationMany projects dependent on collaborationGrowing consensus that team science is Growing consensus that team science is discouraged by recognition of only one PI. discouraged by recognition of only one PI. Other Federal agencies have recognized co-PIs for Other Federal agencies have recognized co-PIs for years years
To avoid confusion, the term “Co-PI” will not To avoid confusion, the term “Co-PI” will not be used by NIHbe used by NIHThe application is the same as it would be for a The application is the same as it would be for a single PI, with the exception of an expanded list of single PI, with the exception of an expanded list of PIs and a PIs and a Leadership PlanLeadership Plan. .
Fiscal Year
Age
- Average MD age > 44
Average age of New Investigators at initial R01/R29 award
43.3
36.7
38.3
39.6
42.7 43.2
39.3 39.1 39.3
42.8
41.7
34.3
36.8
38.9
41.6
34
36
38
40
42
44
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
MD
MD-PhD
PhD
Linear (PhD)
Linear (MD)
NIH Peer Review of Grant NIH Peer Review of Grant ApplicationsApplications
for Clinical Researchfor Clinical ResearchKotchen, et al. JAMA 2004;291:836Kotchen, et al. JAMA 2004;291:836
Conclusion:Conclusion:– Although physicians compete favorably in the Although physicians compete favorably in the
peer review process, review outcomes are peer review process, review outcomes are modestly less favorable for grant applications modestly less favorable for grant applications for clinical research than for laboratory for clinical research than for laboratory research.research.
Automated Referral Workflow System
Referral MethodReferral Method PercentagePercentage
PI assignment request automatically PI assignment request automatically mined from cover lettermined from cover letter
4747
Machine learning prediction when no PI Machine learning prediction when no PI request and > 80% likelihood of request and > 80% likelihood of agreement with human expertsagreement with human experts
3939
Remainder referred by human expertsRemainder referred by human experts 1414
- How does my grant get to the right place?
Travel - savingsTravel - savings
Purchase non-refundable (restricted) coach Purchase non-refundable (restricted) coach tickets instead of unrestricted ticketstickets instead of unrestricted tickets
Preliminary Pilot Data – June to November Preliminary Pilot Data – June to November 20062006
# of tickets issued # of tickets issued 9,1349,134
Changes requested Changes requested 658658
cost of changes + fees cost of changes + fees $175,321$175,321
YTD Fare SavingsYTD Fare Savings $4,742,251$4,742,251
Update on CTSAsUpdate on CTSAs
P20 applicationP20 application
Need better COBRE planningNeed better COBRE planning
Update on UofL CTSA, Update on UofL CTSA, LICTS, and UofL LICTS, and UofL
Research ChallengesResearch Challenges
University of Louisville ’s CTSA
President’s OfficePresident
Provost Executive VP for Research
Director, LICTS
Internal Advisory Committee-Deans-Hospitals-Others
LICTS Executive Committee-Community-Education-Biostatistics/Bioinformatics-Methologies/Resources-Pilots-Regulatory/Ethics
Director, Education
Community Biostatistics/Bioinformatics
Partners in Innovation Pilots Education
OutreachAHECTroverClinicHealth Depts.
Biostat. ConsultingBioinformaticsE-record
Drug developmentDevices
Studies Interdisciplinary MS/PhDTraining grantsCurriculum Dev.
External Advisory Committee
RegulatoryHospitalsFacilities/Cores Ethics
Executive VP for Health Affairs
Top priority of many institutionsTop priority of many institutions
UofL needs to evaluate goalsUofL needs to evaluate goals
CTSA/LICTS Challenges and CTSA/LICTS Challenges and GoalsGoals
Top 10 ListTop 10 List1. 1. University CTSA Goals—Need SummitUniversity CTSA Goals—Need Summit2. Institute Status2. Institute Status3. Director Position3. Director Position4. Space Issues—Short and Long Term4. Space Issues—Short and Long Term5.5. Education—Degree GrantingEducation—Degree Granting6.6. U of L Internal support for Education InitiativesU of L Internal support for Education Initiatives7.7. Be prepared to submit institutional grants, such as K12, Be prepared to submit institutional grants, such as K12,
K30, T32s, etc., and individual K, T, F grantsK30, T32s, etc., and individual K, T, F grants8.8. Research Partners (e.g., Humana, Jewish, Norton, Research Partners (e.g., Humana, Jewish, Norton,
Metacyte)Metacyte)9.9. Biostatistics/Bioinformatics supportBiostatistics/Bioinformatics support10. Budget/Financial Support10. Budget/Financial Support
Dave’s Top 10
Craig’s Top 10
University of Louisville Research Goals/IssuesUniversity of Louisville Research Goals/IssuesTop 10 ListTop 10 List
1. 1. University Mission/Goals/Long Range PlanUniversity Mission/Goals/Long Range Plan2. 2. Bridge FundingBridge Funding3. 3. Start-up FundsStart-up Funds4. 4. Limited Hospital SupportLimited Hospital Support5. 5. “Flat Line” NIH Budget“Flat Line” NIH Budget
● ● Understand NIH RoadmapUnderstand NIH Roadmap● ● Understand Changes at NIHUnderstand Changes at NIH
6. 6. Clinical Trials IssuesClinical Trials Issues● ● Identify it as a problem that needs to be fixedIdentify it as a problem that needs to be fixed
Contracting, Western IRB, Facility support—e.g., CRC,Contracting, Western IRB, Facility support—e.g., CRC,MalpracticeMalpractice
7. 7. Building Partnerships in Research (e.g., Humana) and including our local Building Partnerships in Research (e.g., Humana) and including our local community partners (e.g., Norton, Jewish, Kindred, West End, Louisville Metro community partners (e.g., Norton, Jewish, Kindred, West End, Louisville Metro Health Dept., etc.) and regional partners (e.g., AHEC)Health Dept., etc.) and regional partners (e.g., AHEC)
8.8. More HSC interactions with Belknap (Engineering, Business, Social Work, A&S, More HSC interactions with Belknap (Engineering, Business, Social Work, A&S, Graduate School,Education/Human Development)Graduate School,Education/Human Development)
9. 9. Better Use of Existing U of L Research Resources (decreased duplication, better Better Use of Existing U of L Research Resources (decreased duplication, better core use/support, core use/support, space plan)space plan)
10. Accessibility and Expansion of Biostatistics/Bioinformatics10. Accessibility and Expansion of Biostatistics/Bioinformatics
Dave’s Top 10
Craig’s Top 10