The Agency for Health Care Policy and Research (AHCPR), the Federal Government's focal point for health services research, is streamlining its research grant application and peer review procedures to save investigators time, effort, and money. A number of these changes are consistent with procedures adopted by the National Institutes of Health (NIH) and complement other NIH streamlining initiatives in progress. In adopting the changes described below, AHCPR expects to better serve the health services research community.
AHCPR is a component of the U.S. Department of Health and Human Services' Public Health Service. The Agency's research projects examine the availability, quality, and costs of health services; ways to improve the effectiveness and appropriateness of clinical practice, including the prevention of disease; and other areas of health services research. AHCPR uses grants to carry out extramural research projects, demonstrations, and evaluations. It also supports small grants ($50,000 and under), conference grants, and training through dissertation grants and National Research Service Awards (NRSA) to institutions and individuals. Areas of specific research interest to AHCPR are announced in the NIH Guide for Grants and Contracts (NIH Guide).
The following revisions, which AHCPR has adopted or is developing further in anticipation of adopting, apply to most investigator-initiated grant applications with direct costs of more than $50,000. They do not apply to applications submitted for small project, conference, or doctoral dissertation grants.
1. Streamlining summary statements: Effective with the October 1997 grant application receipt cycle, AHCPR will begin pilot implementation of a streamlined system for preparation of statements that summarize the comments and recommendations of the peer reviewers. Full implementation will begin with the June 1998 application receipt cycle.
The new format will consist of a summary of the review group's discussion (when applicable) and a description of the proposed project from the investigator's abstract. Applicants will be provided with lightly edited, anonymous critiques by individual reviewers, as opposed to a synthesized document. These changes are designed to enhance the quality of information that the Agency provides to applicants and for more timely notification of the results of peer review. AHCPR's announcement of this policy was published in the NIH Guide on April 11, 1997 (Vol. 26, No. 12).
2. Limiting the number of resubmissions: This policy limits to two the number of times an applicant can resubmit a grant application. The policy affords applicants an opportunity to reconsider their research plans by redesigning them to take into account more current and relevant information. Its adoption by AHCPR was announced in the NIH Guide (Vol. 26, No. 12) on April 11, 1997.
3. Inviting concept letters as an adjunct to technical assistance: Under this proposal, AHCPR would invite applicants to submit concept papers as a means of facilitating staff-provided technical assistance as well as communications between applicants and the Agency. This would allow applicants to fine-tune their research ideas and possibly avert spending valuable time and energy on topics that are outside the programmatic interests of AHCPR.
4. Adopting "just in time" procedures: Under this proposed policy, applicants would submit certain detailed elements of an application once AHCPR has determined that it is likely to be funded. The type of information they would be asked to submit subsequent to review includes: 1) detailed aspects of the budget, 2) information on other extramural support, and 3) the checklist of assurances. This process, which would initially be implemented on a trial basis, is expected to conserve time and resources for applicant institutions.
5. Expediting the deferral process: Under this proposed new procedure, immediately following a review meeting, AHCPR would seek additional information from investigators whose applications are otherwise meritorious but lack detail on a key issue. Upon receipt of the requested information, assigned reviewers would provide their final assessment of the application—usually within 1 week of adjournment of the study section meeting. Implementation of this procedure would cut the time consumed by the current deferral process by at least 4 months, avoiding placement of the application into the next review cycle.
6. Requiring advance approval for direct costs of more than $500,000: Under this proposed policy, AHCPR would require that applicants obtain advance approval before submitting an application with direct costs of more than $500,000 in any year. This requirement would minimize the amount of resources the applicant needs to prepare an application (particularly if the topics lack relevance to the Agency's mission) and would enhance AHCPR's ability to provide advice and technical assistance to health services researchers.
7. Reconfiguring initial review group: AHCPR's peer review structure would be reconfigured under this proposal to more clearly reflect current key issues in the field of health services research. Four subcommittees, or study sections, would be established under a single health services research initial review group (IRG), with people having expertise in core disciplines being assigned to each subcommittee. In addition, review administrators for each study section would augment core membership by calling on members of a pool of people with specialized expertise who would be assigned as needed to review specific applications.
8. Triaging applications for review: Many applications reviewed at study section meetings have no chance of being scored in the fundable range, even with modifications. Discussing such applications reduces the time the group has for discussing applications that have greater scientific merit. To avoid this problem yet provide all applicants the benefits of a thorough, objective review of their applications, AHCPR study sections will begin identifying applications that lack sufficient scientific merit in advance of the review meeting on a pilot basis, starting in June 1997. These applications will not be discussed during the review meeting unless one or more members request discussion. All applicants whose applications are not discussed will receive unedited critiques of their applications prepared by the assigned reviewers.
9. Augmenting percentile scores: Increasingly, the practical value of using percentile rankings of grant applications as a guide for making funding decisions has been questioned. It is especially questioned when two applications with similar scores present very different opportunities in terms of policy relevance or "value" (reflecting the potential results or impact of the study in relation to the size of the budget). Different approaches to designing and using an additional score to reflect the "value" dimension will be developed and tested.
Adoption of most of the foregoing proposed changes, as well as any other new or modified grant application and review procedures, will be announced in the NIH Guide, through AHCPR's Web site (www.ahrq.gov/fund/), and inResearch Activities, the Agency's free monthly newsletter. For more information, contact:
Office of Extramural Research, Education and Priority Populations
540 Gaither Road, Suite 2000
Rockville, MD 20850
Current as of November 1998
AHCPR Publication No. 97-R069
Funding Opportunities
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