The National Institutes of Health is the world's largest public funder of biomedical research. In 2021, the agency granted some $32 billion to research efforts in the US.
While all investment in research that results in new medical treatments and therapies is warranted, there's one glaring problem with the NIH funding mechanism.
Roughly 70% of its grants go to 10% of NIH-funded institutions. That means the other 90% of NIH-funded organizations receive only 30% of grant funds.
That's a disparity. Fortunately, NIH has recognized the need for a revamped scoring system that reduces or eliminates "reputational bias." As a result, a new way to score NIH grants is in the works and could go into effect in 2025.
Where NIH funding goes
According to US News and World Report, the top academic medical center recipients of NIH funding in 2021 include:
- Harvard University ($1.9 billion)
- University of Washington ($1 billion)
- University of California – Los Angeles ($900 million)
- Cornell University ($800 million)
- Duke University ($720 million)
- University of Pennsylvania ($700 million)
- Columbia University ($693 million)
- Johns Hopkins University ($660 million)
- University of California – San Francisco ($656 million)
- Washington University in St. Louis ($655 million)
Does that mean these are the only academic institutions conducting cutting-edge research? Of course not.
Rather, some say it shows schools' and scientists' reputations count for more than the strength of their ideas. In other words, a proposal submitted by a research powerhouse like Harvard may get approved with little scrutiny during the peer-review process.
Noni Byrnes, director of NIH's Center for Scientific Review (CSR), confirmed the notion in an article published in Science.
"Anyone who actually attends a study section sees [reputational bias] happening," she is quoted as saying.
While her opinion is anecdotal at best, plenty of evidence supports inequities in the distribution of NIH funds.
Simplifying review criteria
Researchers have offered plenty of suggestions for improving the process. For example, anonymized grant review protocols have been tested, but 20% of applicants could be identified through information in the grant package. Blinding reviewers to applicants' race has been tested but only partially eliminated reviewers' ability to identify the applicant. In 2017, NIH tried capping the number of grants a researcher could hold at any time, but harsh criticism from the research community stopped the idea from moving forward.
In 2020, CSR formed an advisory group to decrease bias in the awards process while reducing reviewers' workload. The group's proposed changes would "facilitate the mission of scientific peer review – identification of the strongest, highest-impact research."
Under the current model, peer reviewers use five primary criteria to score applications:
The revamped criteria use only three factors, two of which receive a numerical score (1-9). Reviews will consider all three factors to arrive at an Overall Impact Score for the application's scientific and technical merit.
Factor 1: Importance of the Research (Significance, Innovation), numerical score given.
Factor 2: Rigor and Feasibility (Approach), numerical score given.
Factor 3: Expertise and Resources (Investigator, Environment). Investigator(s) will be rated as "fully capable" or "additional expertise/capability needed." Environment will be rated as "appropriate" or "additional resources needed."
"Additional Review Criteria" such as Human Subject Protections, Biohazards, Renewal and others will remain essentially unchanged. These criteria will not receive individual scores but will affect the Overall Impact Score.
Feedback and Comment
NIH leaders caution these changes will take time and review. Any changes to review criteria must adhere to the Code of Federal Regulations and the 21st Century Cures Act. Additionally, the process will include feedback from NIH's Office of Extramural Research, eRA, NIH Institutes and Centers, Office of the General Counsel and other stakeholders.
Finally, NIH has asked for public comment on the proposed changes until March 10, 2023. You can read about the proposal in detail and submit your comments online.
Hopefully, this is a step in the right direction to improve equity among NIH grant recipients. In the meantime, strengthen your grant writing skills by taking our self-paced course.