Peering into Peer Review

Why don’t proposals given better scores by the National Institutes of Health lead to more important research outcomes?

Michael Lauer’s job at the National Institutes of Health (NIH) is to fund the best cardiology research and to disseminate the results rapidly to other scientists, physicians, and the public. But NIH’s peer-review system, which relies on an army of unpaid volunteer scientists to prioritize grant proposals, may be making it harder to achieve that goal. Two recent studies by Lauer, who heads the Division of Cardiovascular Sciences at NIH’s National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, Maryland, raise some disturbing questions about a system used to distribute billions of dollars of federal funds each year.

Lauer recently analyzed the citation record of papers generated by nearly 1500 grants awarded by NHLBI to individual investigators between 2001 and 2008. He was shocked by the results, which appeared online last month in Circulation Research: The funded projects with the poorest priority scores from reviewers garnered just as many citations and publications as those with the best scores. That was the case even though low-scoring researchers had been given less money than their top-rated peers.