Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
JAMA Pediatr. 2021 Dec 1;175(12):1236-1243. doi: 10.1001/jamapediatrics.2021.3360.
The US National Institutes of Health (NIH) is the largest government funding source for biomedical research globally. Burden of disease is one of the factors considered by the NIH in making funding allocations, though it is not known how funding patterns are associated with disease burden for pediatric conditions.
To determine the correlation between NIH funding and disease burden across pediatric conditions.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study evaluates NIH grants funding pediatric research from 2015 to 2018 in the US. Pediatric grants were classified according to disease categories studied. Disease burden for each category was determined using measures from the Institute of Health Metrics and Evaluation and hospitalization data from the 2016 Kids' Inpatient Database.
Correlation between NIH funding and pediatric disease burden using Spearman rank order coefficients and predicted amounts of disease-specific funding based on disease burden estimated from linear regression models.
This study analyzed 14 060 disease-specific pediatric grants awarded by the NIH from 2015 to 2018 in the US. Annual funding for disease categories ranged from $0 to $382 849 631. Funding for pediatric research was correlated with pediatric disability-adjusted life-years (DALYs), deaths, years lived with disability, and years of life lost (r, 0.56-0.63; P < 0.001 for all measures). There was also a correlation between funding and hospital-based metrics, including hospital days, number of hospital admissions, and hospital charges (r, 0.67-0.69; P < .001 for all measures). Eight disease categories received greater than $500 million more than predicted levels relative to DALYs, while 5 disease categories were funded more than $50 million less than predicted levels. Based on predicted levels of funding, congenital birth defects; endocrine, metabolic, blood, and immune disorders; and HIV/AIDS were the most overfunded categories relative to DALYs and hospital days. Conditions identified as most underfunded differed depending on use of DALYs or hospital days in estimating predicted funding levels.
NIH funding for pediatric research was correlated with pediatric disease burden in the US with variable correlation based on the disease metric applied. There was substantial overfunding and underfunding of certain conditions. Ongoing evaluation of pediatric funding patterns using a complementary set of disease measures may help inform and prioritize pediatric research funding.
美国国立卫生研究院（NIH）是全球最大的政府生物医学研究资金来源。疾病负担是 NIH 在进行资金分配时考虑的因素之一，但尚不清楚资金模式与儿科疾病负担之间的关系如何。
确定 NIH 对儿科疾病的资金投入与疾病负担之间的相关性。
设计、地点和参与者：本横断面研究评估了 2015 年至 2018 年美国 NIH 资助的儿科研究项目。根据研究的疾病类别对儿科资助进行分类。使用健康计量研究所的测量指标和 2016 年儿童住院数据库中的住院数据来确定每个类别的疾病负担。
使用 Spearman 等级相关系数和基于疾病负担从线性回归模型中估计的特定疾病的预测资金量，评估 NIH 资金与儿科疾病负担之间的相关性。
本研究分析了 2015 年至 2018 年美国 NIH 授予的 14060 项特定疾病的儿科资助。疾病类别的年度资金从 0 到 382849631 美元不等。儿科研究资金与儿科残疾调整生命年（DALY）、死亡、残疾生存年和生命损失年呈正相关（r，0.56-0.63；所有指标均 P<0.001）。资金与基于医院的指标也呈正相关，包括住院天数、住院人数和住院费用（r，0.67-0.69；所有指标均 P<0.001）。有 8 个疾病类别获得的资金比根据 DALY 预测的水平高出 5 亿多，而有 5 个疾病类别获得的资金比根据预测水平低 5 亿多。根据预测的资金水平，先天性出生缺陷；内分泌、代谢、血液和免疫障碍；和艾滋病是与 DALY 和住院天数相比资金最超支的类别。根据估计预测资金水平时使用的 DALY 或住院天数，确定最资金不足的条件有所不同。
美国 NIH 对儿科研究的资助与儿科疾病负担相关，其相关性因应用的疾病指标而异。某些疾病存在大量的过度和不足资金。使用一组补充的疾病指标对儿科资金模式进行持续评估，可能有助于为儿科研究资金提供信息并确定其优先级。
