Department of Orthopaedic Surgery, Howard University Hospital, Washington, D.C.
Department of Orthopaedics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
J Bone Joint Surg Am. 2021 Nov 17;103(22):e90. doi: 10.2106/JBJS.20.01754.
The National Institutes of Health (NIH) supports mentored research career development awards (K awards) to increase the pipeline of independently funded scientists. This study analyzed the portfolio of K grants that were awarded to orthopaedic surgery departments and characterized the factors that were associated with successful transition to independent NIH research funding, including R01 grants.
This was a retrospective cohort study of K-award recipients in orthopaedic surgery departments in the United States from 1996 to 2018. A query was performed on the NIH Research Portfolio Online Reporting Tools (RePORT) database for NIH grants that were awarded to departments of orthopaedic surgery, general surgery, otolaryngology, obstetrics and gynecology, ophthalmology, and urology. Rates of transition to independent research funding were compared by specialty for K grants that were awarded from 1996 to 2011. The percentage of faculty with mentored research career development awards and the return on investment (ROI) were calculated. An internet and Scopus (Elsevier) database search determined the investigator characteristics. The factors that were associated with successful transition to independent funding were determined via chi-square and unpaired t tests.
Sixty K-award recipients were identified in orthopaedic surgery departments. Most were men (77%) and research scientists (53%). Fifty percent of the K-award recipients transitioned to independent research funding. Research scientists had the highest rate of transition to independent research funding (71%, p = 0.016) relative to clinicians (0%) and orthopaedic surgeons (40%). Higher levels of publication productivity were associated with successful transition to independent research funding. Similar rates of transition to independent research funding existed among surgical specialties (p = 0.107). Orthopaedic surgery had the lowest percentage of faculty with a K award (1.4%) but had the highest ROI (198%) of these awards.
Orthopaedic surgery had similar rates of transition to independent research funding when compared with other surgical specialties but had a lower prevalence of K awards among faculty. Orthopaedic surgeon-scientists have lower rates of transition to independent research funding when compared with their research-scientist colleagues. These findings highlight a need for greater support to foster the pipeline of future NIH-funded orthopaedic investigators.
As the largest support of biomedical research in the U.S., the NIH is an important stakeholder in orthopaedic innovations and discoveries. This study highlights barriers in the procurement of NIH funding across surgical specialties and affirms the need for greater resources toward supporting NIH funding in orthopaedic surgery.
美国国立卫生研究院（NIH）支持以导师指导的研究职业发展奖（K 奖），以增加独立资助科学家的人才储备。本研究分析了授予骨科系的 K 奖组合，并确定了与成功过渡到 NIH 独立研究资助相关的因素，包括 R01 资助。
这是一项在美国国立卫生研究院研究组合在线报告工具（RePORT）数据库中检索的 1996 年至 2018 年期间接受 K 奖的骨科系的回顾性队列研究。对授予骨科、普通外科、耳鼻喉科、妇产科、眼科和泌尿科系的 NIH 资助进行了查询。比较了 1996 年至 2011 年期间授予的 K 奖在各专业之间向独立研究资助过渡的比率。计算了有导师指导的研究职业发展奖的教员比例和投资回报率（ROI）。通过互联网和 Scopus（爱思唯尔）数据库搜索确定了研究者特征。通过卡方检验和独立样本 t 检验确定了与成功过渡到独立资助相关的因素。
在骨科系共确定了 60 名 K 奖获得者。他们大多数是男性（77%）和研究科学家（53%）。50%的 K 奖获得者过渡到独立的研究资助。研究科学家向独立研究资助过渡的比例最高（71%，p = 0.016），而临床医生（0%）和骨科医生（40%）则较低。较高的发表生产力与成功过渡到独立研究资助相关。不同外科专业之间向独立研究资助过渡的比率相似（p = 0.107）。骨科系有 K 奖的教员比例最低（1.4%），但这些奖项的投资回报率最高（198%）。
与其他外科专业相比，骨科向独立研究资助过渡的比率相似，但在教员中 K 奖的比例较低。与他们的研究科学家同事相比，骨科医生科学家向独立研究资助过渡的比例较低。这些发现突出表明需要更多的支持来培养未来 NIH 资助的骨科研究人员。
作为美国最大的生物医学研究资助者，NIH 是骨科创新和发现的重要利益相关者。本研究强调了外科各专业获取 NIH 资助的障碍，并肯定了需要更多资源来支持骨科的 NIH 资助。
