What We Know and Do Not Know About the NIH Peer Review System
Reviews recent literature concerning the peer review system used by the National Institutes of Health. It describes the fairly extensive literature on how funding decisions and biomedical research policies influence activities within the scientific community. In most cases, findings concerning the system's effect on scientific careers are generally reassuring. In particular, (1) the peer review system supports many new researchers, (2) most researchers who have trouble securing funding nevertheless continue their careers, and (3) for most medical specialties, research involvement remains level throughout the mid-career period. The Note then surveys the more limited information concerning the system's influence on the quality of research. While there are indications that the peer review system has worked quite well, a literature review suggests two major gaps in the understanding of how the system works and thus how it might be improved: (1) the system's effect on innovative high-risk research, and (2) the validity and reliability of priority scores used by the system.