Core Values of the NIH System

July 10, 2007

Instead of only addressing the core values of the peer review system (that must be retained or enhanced), as requested in the recent RFI from the NIH, I thought I’d highlight the core values of the NIH-funded research system as a whole. This seems a good exercise particularly since many of my posts trend toward critique. It strikes me that many of my criticisms of the NIH arise from a failure of the system to live up to the ideals to a sufficient degree. This is a VeryGoodThing, much better than being in the position of criticizing intentional behavior. So I recognize that these strengths are not perfectly realized. It is, however, important that these are the ideals and goals of the system.

  • Investigator-initiated research: The unswerving belief that the most productive science results from the uncontrolled effort of very smart and well trained individuals is probably the top strength of the NIH system.
  • Democratic participation: The second biggest strength of the NIH is the fact that the identity of who can be a Principal Investigator on a NIH grant is not centrally controlled. In practice, a great diversity of individuals serve as PIs, bringing their various perspectives to bear on the science of their choice.
  • Peer Review: The first and most important level of decision on which proposals are funded is made by a “jury of peers”, fellow PIs working in closely related fields of science. This is a critical component of support for the other strong features of the system.
  • Basic Research: The commitment to exploration for knowledge’s sake with no clearly defined route to a health benefit, product or other tangible outcome is supported by a firm belief that such tangible results will eventual be attained. History has shown us that science is an incremental effort, ever building on prior work and that applications of particular scientific results often develop long after an initial discovery.
  • Public Health Mission: Keeping one eye on the prize, so to speak, runs in tandem with the commitment to basic research, keeping science from getting too far away from a broadly approved public good. After all, the taxpayer are supporting this, they should realize some tangible benefit.
  • Project based funding: The NIH system seeks to fund scientific projects of a specifically defined nature for a finite period of time. This means that what is prioritized is the quality of the specific idea rather than qualities of the individual researcher.
  • Breadth of Institutes and Centers: As in politics, too much democracy can be dangerous. A critical strength of the National Institutes of Health is that the term is plural ensuring that scientific coverage will be broad. This insulates the science mission against swings in popularity for particular types of inquiry that might result from the tyranny of the majority.

7 Responses to “Core Values of the NIH System”

  1. PhysioProf Says:

    Very nicely put! I would further emphasize that it is an absolutely essential feature of the system that it is not purely practical-outcome-driven. This is because for very difficult-to-achieve goals, such as curing diseases, the more one focuses on the goal, the less likely it is to be achieved.

    The more that the system allows biomedical researchers to simply follow their curiosity, the more likely it is to lead to cures. The book, “The Black Swan”, by Nassim Taleb, makes this point very effectively, albeit in a more general context.

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  2. drugmonkey Says:

    I thought I hit on that under “Basic Research”. Perhaps not well enough given that my bias leans more toward the applied these days! I actually sort of favor the leash-yanking that occurred under the “translational” hoopla of the past few years. I don’t like those types who disdain any possible application of their work as a talisman of the “purity” and therefore superiority of their work. You allude to an “Ivy league” training path, I imagine you’ve come across this type a time or two.

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  3. PhysioProf Says:

    I agree that disdain for practicality is distasteful. The problem I have with “translational” research, is that I really believe that the harder you try to intentionally “translate” basic science to clinical relevance, the *less* likely you are to actually get there.

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  4. drugmonkey Says:

    I think it is good that we have a balance. First, different research groups might lean one way or the other as one level of balance. Second, reviewers might ask the “applied” types for more “mechanistic explanations” while others ask the more “basic” types for “relevance”. We advance best when we try to partially satisfy the other side as best we can rather than stiff-arming with “I do BASIC research, it doesn’t have to have any relevance” or, alternately “Hey, it works, it has predictive validity, who cares about mechanism” responses.

    As a practical matter this has been a struggle for my study section. We have a LOT of resistance to the idea of “translational significance” despite the whole Insel/NIHM thing saying hey, we’re not funding basic behavioral research without any whiff of translational appeal, folks. And we get applicants that are not helping any either. So in some cases the section likes a proposal pretty well but NIMH fails to pick it up. My position is, is it really that hard to dream up an application for your work? That hard to do an experiment or two that is obviously relevant to health? Lesion a brain region, inject a drug, select your human population carefully…c’mon, something!

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  5. PhysioProf Says:

    What you say makes sense.

    I am right now wrestling with a study section over an R21 application that I submitted in response to a PA soliciting “Exploratory/Developmental Projects in Translational Research”. The whole stated purpose of the PA in relation to the R21 mechanism is to fund initial-stage studies that will attempt to identify either candidate targets for treatment or candidate treatments. The explicitly stated idea is that then you would apply for additional funding–like a cooperative translational U01–to pursue preclinical testing if the proposed studies result in candidates.

    For some reason, the study section is not really following either of the stated purposes of the PA.

    First, they are complaining that I haven’t “established” that it is “feasible” that I will definitely identify candidates. They seem to be asking for preliminary evidence of a particular candidate. Well, isn’t the whole purpose of an “Exploratory” grant funded via R21 to explore, and see if anything is there, and thereby possibly identify candidates?

    Second, they are complaining that I haven’t proposed experiments that go beyond the identification of a candidate, and examine things like the specificity of the candidate, and other properties that will ultimately determine if it has any possible clinical value. Well, isn’t that the purpose of the explicit plan for pre-clinical testing *after* the identification of candidates, and not supposed to be part of the proposal?

    I’m not sure how to deal with these criticisms of my A1. And I wonder if the SRA–who is new to this study section and didn’t administer review of the original submission–didn’t really properly guide the panel in light of the PA. Evidence of an SRA out of his league is that the Resume of Discussion is mostly just sentences lifted from one of another of the written reviews.

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  6. Neuro-conservative Says:

    Drugmonkey — I greatly appreciate your website and what you are trying to do here. That said, my sympathies are with physioprof, both for his comments in the previous thread as well as his experience with study section described above.

    I increasingly find that Program is more forward-thinking, whereas review committees are too often dragged to a lower common denominator, either by a single pedantic member or an overly cautious or turf-based group mindset.

    I know this is heretical, but I would like to see a more equal check-and-balance system, with Program and Council having a somewhat greater role in the process (not merely at the margin). I admit that I am not sure exactly how to accomplish this without many other unintended consequences, and my conservative tendencies lead me to believe that the present system is “the worst possible system, except for all the others.”

    Ultimately, any system will appear capricious and arbitrary when the paylines are this low. Still, it is not only very frustrating, but extremely inefficient, when Program encourages investigators in a particular direction which is then utterly ignored by the study section.

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  7. drugmonkey Says:

    “Still, it is not only very frustrating, but extremely inefficient, when Program encourages investigators in a particular direction which is then utterly ignored by the study section.”

    An excellent point and one I agree with. This definitely falls under an imperfect realization of the balance between pure peer-review and the distribution of research effort inherent in multiple Institutes and Centers.

    I see that in the above list I didn’t really identify secondary levels of review (Program, Advisory Council, etc) as a core strength. I guess I don’t really view the specifics of how scientific diversity is accomplished as a core strength and in some senses Neuro-conservative has gone beyond this anyway. Down to the tactics rather than the strategy.

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