Research is active and diverse in U.S. academic medical centers

Sep 2 2009

A survey indicates that research is active and diverse at U.S. academic medical centers and that a substantial proportion of faculty conduct research and publish without sponsorship, according to a study in the September 2 issue of JAMA.

"Encompassing 60 percent of all research money to universities, the academic, life-science research enterprise is large and growing, representing $28.8 billion in research and development expenditures in 2006," the authors write as background information in the article. "To establish policies and priorities, a better empirical picture is needed of what the academic medical center (AMC) research enterprise looks like, but beyond generic classifications such as 'basic' and 'applied,' these data do not exist."

Darren E. Zinner, Ph.D., of Brandeis University, Waltham, Mass., and Eric G. Campbell, Ph.D., of Massachusetts General Hospital and Harvard Medical School, Boston, conducted a study to quantitatively document the state of academic research in AMCs through a survey of research faculty. The survey, conducted in 2007, was mailed to 3,080 life-science faculty at the 50 universities with medical schools that received the most funding from the National Institutes of Health in 2004. The overall response rate was 74 percent, with questions on the survey regarding the type of research (basic, translational, clinical trials, health services research/clinical epidemiology, multimode, other), total funding, industry funding, publications, professional activities, patenting behavior and industry relationships.

Survey results indicated that one-third (33.6 percent) of AMC faculty members exclusively conducted basic science research as principal investigators, compared with translational researchers (9.1 percent), clinical trial investigators (7.1 percent), and health services research/clinical epidemiologists (9.0 percent). Those who solely conducted other clinical research represented 11.6 percent of research staff and were generally less focused on research.

"While principal investigators garnered a mean of $410,755 in total annual research funding, 22.1 percent of all AMC research faculty were unsponsored, a proportion that ranged from 11.5 percent for basic science researchers to 46.8 percent for health services researchers. The average AMC faculty member received $33,417 in industry-sponsored funding, with most of this money concentrated among clinical trial ($110,869) and multimode ($59,916) principal investigators. Translational (61.3 percent), clinical trial (67.3 percent), and multimode (70.9 percent) researchers were significantly more likely than basic science researchers (41.9 percent) to report a relationship with industry and that these relationships contributed to their most important scientific work," the authors write.

The researchers add that these findings suggest several implications. "First, contrary to popular belief, the 'valley of death' for translational research actually appeared to be quite fertile within AMCs. At the time of this survey in 2007, 22 of 50 institutions were participating members of the Clinical and Translational Science Awards (CTSA) consortium; another 12 joined in 2008. … Second, multimode investigators represented an understudied population. These investigators, who conducted research across the spectrum of research activities, reported both substantial scientific and commercializing characteristics. … Third, the findings also demonstrate the important role of industrial collaboration in scientific advancement. Academic-industry relationships provide substantial, tangible benefits to both the science and the scientist."

In an accompanying editorial, Hamilton Moses III, M.D., of the Alerion Institute, North Garden, Va., and Johns Hopkins University School of Medicine, Baltimore, writes that the authors of this study "acknowledge that one group's scientific discovery is another's clinical advance and still another's incremental cost."

"However, to date, there is no workable compromise among those competing aims. Momentum behind health reform in the United States favors coverage of the uninsured and cost control as 2 main goals. In the absence of good information about which technologies save money and which add only expense or marginal value, the result will be increasing pressure to direct investment toward the greatest burden of disease. The debate over research priorities has already begun."