Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
Clin Orthop Relat Res. 2023 Jul 1;481(7):1265-1272. doi: 10.1097/CORR.0000000000002556. Epub 2023 Jan 17.
National Institutes of Health (NIH) funding is a key driver of orthopaedic research, but it has become increasingly difficult to obtain in recent years. An understanding of the types of grants that are commonly funded, how productive they are, and the factors associated with obtaining funding may help orthopaedic surgeons better understand how to earn grants.
QUESTIONS/PURPOSES: In this study, we sought to determine (1) the proportion of current academic orthopaedic surgeons who have obtained NIH grant funding, (2) the productivity of these grants by calculating grant productivity metrics, and (3) the factors (such as gender, subspecialty, and additional degrees) that are associated with obtaining grant funding.
Current academic orthopaedic surgeons at the top 140 NIH-funded institutions were identified via faculty webpages; 3829 surgeons were identified. Demographic information including gender (men constituted 88% of the group [3364 of 3829]), academic rank (full professors constituted 22% [856 of 3829]), additional degrees (those with MD-PhD degrees constituted 3% [121 of 3829]), leadership positions, and orthopaedic subspecialty was collected. Funding histories from 1985 through 2021 were collected using the NIH Research Portfolio Online Reporting Tools Expenditures and Results. Grant type, funding, publications, and citations of each article were collected. A previously used grant impact metric (total citations per USD 0.1 million) was calculated to assess grant productivity. Multivariable binomial logistic regression was used to evaluate factors associated with obtaining funding.
Four percent (150 of 3829) of academic orthopaedic surgeons obtained USD 338.3 million in funding across 301 grants, resulting in 2887 publications over the entire study period. The R01 was the most commonly awarded grant in terms of the total number awarded, at 36% (108 of 301), as well as by funding, publications, and citations, although other grant types including T32, F32, R03, R13, and R21 had higher mean grant impact metrics. There was no difference between men and women in the by-gender percentage of academic orthopaedic surgeons who obtained funding (4% [135 of 3229] versus 3% [15 of 450]; odds ratio 0.9 [95% confidence interval 0.5 to 1.7]; p = 0.80). A department having a single funded PhD researcher may be associated with surgeon-scientists obtaining grant funding, but with the numbers available, we could not demonstrate this was the case (OR 1.4 [95% CI 0.9 to 2.2]; p = 0.12).
Fewer than one in 20 academic orthopaedic surgeons have received NIH funding. R01s are the most commonly awarded grant, although others demonstrate increased productivity metrics. Future studies should investigate the role of co-principal investigators on productivity and the role of different funding sources.
Individuals should pursue both R01 and non-R01 grants, and departments should consider cultivating relationships with funded PhDs. The specific research infrastructure and departmental policies of the most productive institutions and grants should be surveyed and emulated.
美国国立卫生研究院（NIH）的资金是骨科研究的主要驱动力，但近年来，获得 NIH 资金变得越来越困难。了解通常获得资助的拨款类型、它们的生产力以及与获得资助相关的因素，可能有助于骨科医生更好地了解如何获得拨款。
问题/目的：在这项研究中，我们试图确定：(1) 当前获得 NIH 拨款资助的学术骨科医生的比例；(2) 通过计算拨款生产力指标来评估这些拨款的生产力；(3) 与获得拨款资助相关的因素（如性别、亚专科和额外学位）。
通过教员网页确定了前 140 家 NIH 资助机构的现任学术骨科医生；共确定了 3829 名外科医生。收集了包括性别（男性占该组的 88%[3364/3829]）、学术职称（正教授占 22%[856/3829]）、额外学位（拥有 MD-PhD 学位的人占 3%[121/3829]）、领导职位和骨科亚专科等在内的人口统计学信息。使用 NIH Research Portfolio Online Reporting Tools Expenditures and Results 收集了 1985 年至 2021 年的资助历史。收集了每个项目的拨款类型、资金、出版物和引文。计算了先前使用的拨款影响指标（每 0.1 百万美元的总引文数），以评估拨款的生产力。使用多变量二项逻辑回归评估与获得资助相关的因素。
在整个研究期间，3829 名学术骨科医生中有 4%（150/3829）获得了 3.383 亿美元的资助，共获得了 2887 篇出版物。从拨款总数、拨款、出版物和引文来看，R01 是最常授予的拨款类型，占 36%（108/301），但其他拨款类型，包括 T32、F32、R03、R13 和 R21 的平均拨款影响指标更高。按性别划分，获得资助的学术骨科医生中，男性和女性的比例没有差异（4%[135/3229]与 3%[15/450]；比值比 0.9[95%置信区间 0.5 至 1.7]；p=0.80）。一个部门有一个获得资助的博士研究员可能与外科医生获得拨款资助有关，但由于可用数据有限，我们无法证明这一点（比值比 1.4[95%置信区间 0.9 至 2.2]；p=0.12）。
不到 1/20 的学术骨科医生获得了 NIH 资助。R01 是最常授予的拨款类型，尽管其他拨款类型的生产力指标更高。未来的研究应调查共同主要研究者对生产力的作用以及不同资助来源的作用。
个人应同时追求 R01 和非 R01 拨款，并且部门应考虑与获得资助的博士建立关系。应调查和效仿最有生产力的机构和拨款的具体研究基础设施和部门政策。
