1Department of Orthopaedic Surgery, Howard University Hospital, Washington, DC.
2University of California San Francisco School of Medicine, San Francisco, California; and.
J Neurosurg Spine. 2023 Jul 28;39(6):807-814. doi: 10.3171/2023.7.SPINE23101. Print 2023 Dec 1.
Surgeon scientists remain underrepresented among recipients of National Institutes of Health (NIH) grants despite their unique ability to perform translational research. This study elucidates the portfolio of NIH grants awarded for degenerative spine diseases and the role of spine surgeons in this portfolio.
The most common diagnoses and surgical procedures for degenerative spine diseases were queried on the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database (2011-2021). Total NIH funding was extracted for 20 additional clinical areas and compound annual growth rates (CAGRs) were calculated. A retrospective cohort study of principal investigators (PIs) was conducted. NIH grants and funding totals were extracted and compared to those from other clinical areas.
The total NIH research budget increased from $31 to $43 billion over the 10-year period (CAGR 3.4%). A total of 273 unique grants equaling $91 million (CAGR 0%) were awarded for degenerative spine diseases. Diabetes ($11.8 billion, CAGR 0%), obesity ($10.6 billion, CAGR 3%), and chronic pain ($5.6 billion, CAGR 7%) received the most funding. Most NIH funding for degenerative spine disease research was awarded through the R01 (66%) and R44 (8%) grant mechanisms. The National Institute of Arthritis and Musculoskeletal and Skin Diseases awarded the most NIH funding (64%). Departments of orthopedic surgery were awarded the most funding (32%). NIH funding supported clinical (28%), translational (37%), and basic science (35%) research. Disease mechanisms (58%), imaging modalities (20%), and emerging technologies (16%) received the most funding. Nineteen spine surgeons were identified as PIs (16%). There were no significant differences in NIH funding totals by PI demographic and academic characteristics (p > 0.05)-except for full professors, who had the most NIH funding (p = 0.007) and highest h-index values (p < 0.001).
Few spine surgeons receive NIH grants for degenerative spine disease research. Future opportunities may exist for spine surgeons to collaborate in identified areas of clinical interest. Additional strategies are needed to increase NIH funding in spine surgery.
尽管外科医生科学家具有进行转化研究的独特能力,但他们在获得美国国立卫生研究院(NIH)资助方面的代表性仍然不足。本研究阐明了 NIH 授予退行性脊柱疾病的资助计划组合以及脊柱外科医生在该组合中的作用。
在 NIH 研究组合在线报告工具支出和结果(RePORTER)数据库(2011-2021 年)中查询退行性脊柱疾病最常见的诊断和手术程序。为 20 个额外的临床领域提取了 NIH 总资金,并计算了复合年增长率(CAGR)。对主要研究者(PI)进行了回顾性队列研究。提取 NIH 资助和资金总额,并与其他临床领域进行比较。
在 10 年期间,NIH 研究预算总额从 310 亿美元增加到 430 亿美元(CAGR 为 3.4%)。共授予 273 项独特的赠款,总计 9100 万美元(CAGR 为 0%),用于退行性脊柱疾病。糖尿病(118 亿美元,CAGR 为 0%)、肥胖症(106 亿美元,CAGR 为 3%)和慢性疼痛(56 亿美元,CAGR 为 7%)获得的资金最多。退行性脊柱疾病研究的 NIH 大部分资金是通过 R01(66%)和 R44(8%)资助机制授予的。国家关节炎和肌肉骨骼及皮肤病研究所授予的 NIH 资金最多(64%)。矫形外科系获得的资金最多(32%)。NIH 资金支持临床(28%)、转化(37%)和基础科学(35%)研究。疾病机制(58%)、成像方式(20%)和新兴技术(16%)获得的资金最多。确定了 19 名脊柱外科医生作为 PI(16%)。PI 的 NIH 资金总额没有因人口统计学和学术特征而存在显著差异(p > 0.05)-除了正教授,他们获得了最多的 NIH 资金(p = 0.007)和最高的 h 指数值(p < 0.001)。
很少有脊柱外科医生获得 NIH 授予退行性脊柱疾病研究的资助。未来可能有机会让脊柱外科医生在确定的临床关注领域进行合作。需要采取额外的策略来增加脊柱外科的 NIH 资助。