Department of Neurology, University of California San Francisco, San Francisco, California, United States of America.
PLoS One. 2011 Feb 24;6(2):e16837. doi: 10.1371/journal.pone.0016837.
An analysis of NIH funding in 1996 found that the strongest predictor of funding, disability-adjusted life-years (DALYs), explained only 39% of the variance in funding. In 1998, Congress requested that the Institute of Medicine (IOM) evaluate priority-setting criteria for NIH funding; the IOM recommended greater consideration of disease burden. We examined whether the association between current burden and funding has changed since that time.
We analyzed public data on 2006 NIH funding for 29 common conditions. Measures of US disease burden in 2004 were obtained from the World Health Organization's Global Burden of Disease study and national databases. We assessed the relationship between disease burden and NIH funding dollars in univariate and multivariable log-linear models that evaluated all measures of disease burden. Sensitivity analyses examined associations with future US burden, current and future measures of world disease burden, and a newly standardized NIH accounting method.
In univariate and multivariable analyses, disease-specific NIH funding levels increased with burden of disease measured in DALYs (p = 0.001), which accounted for 33% of funding level variation. No other factor predicted funding in multivariable models. Conditions receiving the most funding greater than expected based on disease burden were AIDS ($2474 M), diabetes mellitus ($390 M), and perinatal conditions ($297 M). Depression ($719 M), injuries ($691 M), and chronic obstructive pulmonary disease ($613 M) were the most underfunded. Results were similar using estimates of future US burden, current and future world disease burden, and alternate NIH accounting methods.
Current levels of NIH disease-specific research funding correlate modestly with US disease burden, and correlation has not improved in the last decade.
1996 年对 NIH 资助的分析发现，资金最强的预测因子——伤残调整生命年（DALYs），仅能解释 39%的资金差异。1998 年，国会要求医学研究所（IOM）评估 NIH 资助的优先设定标准；IOM 建议更多地考虑疾病负担。我们研究了自那时以来，当前负担与资金之间的关联是否发生了变化。
我们分析了 2006 年 NIH 对 29 种常见疾病的公共资助数据。2004 年美国疾病负担的衡量指标来自世界卫生组织全球疾病负担研究和国家数据库。我们在单变量和多变量对数线性模型中评估了所有疾病负担衡量指标，评估了疾病负担与 NIH 资助金额之间的关系。敏感性分析研究了与未来美国负担、当前和未来世界疾病负担以及新的 NIH 标准化核算方法的关联。
在单变量和多变量分析中，与疾病负担相关的 NIH 特定疾病的资助水平随着以 DALYs 衡量的疾病负担（p=0.001）而增加，这占了资助水平变化的 33%。多变量模型中没有其他因素可以预测资助。根据疾病负担，获得的资助比预期多的疾病是艾滋病（2474 百万美元）、糖尿病（390 百万美元）和围产期疾病（297 百万美元）。抑郁症（719 百万美元）、损伤（691 百万美元）和慢性阻塞性肺疾病（613 百万美元）是最缺乏资金的疾病。使用对未来美国负担、当前和未来世界疾病负担的估计以及 NIH 替代核算方法，结果相似。
当前 NIH 特定疾病研究资助水平与美国疾病负担适度相关，且在过去十年中相关性并未提高。
