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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Congressionally Directed Medical Research Programs (CDMRP)
Presented to National Institutes of Health
Peer Review Advisory Committee
Presented byJanet Harris, Ph.D., R.N.
Colonel, US Army Nurse CorpsDirector
23 January 2006
US Army Medical Research and Materiel Command (USAMRMC)
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
CDMRP Philosophy
� Vision: Find and fund the best research to eradicate diseases and support the warfighter for the benefit of the American public
� Mission: We provide hope by promoting innovative research, recognizing untapped opportunities, creating partnerships, and guarding the public trust.
THE CENTRAL THEME IS INNOVATION
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
CDMRP History
� 1992: Grassroots advocacy heightened political awareness of breast cancer
� 1993: Congress appropriated $210M to the Department of Defense (DOD) budget for breast cancer research, managed by the CDMRP, after consultation with the Institute of Medicine (IOM) in fiscal year 1993 (FY93) and re-reviewed the program in FY97.
� 1996-2002: Additional research programs added:
� 1996: Neurofibromatosis
� 1997: Prostate Cancer and Ovarian Cancer
� 1999: Peer Reviewed Medical Research Program
� 2002: Prion, Tuberous Sclerosis, and Chronic Myelogenous Leukemia.
� These and other programs are managed by the CDMRP
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
� Funds added to the DOD budget by Congress [generally as DHP(RDT&E)]*
� Respond to targeted guidance from Congress
� Two-tier formal review of proposals – IOM Model
� Consumer advocate participation throughout process
� Vision is adapted yearly to facilitate rapid change and address research gaps
� Highly flexible management processes
CDMRP Unique Features
*Defense Health Program (Research Development, Test and Evaluation)
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
0
50
100
150
200
250
300
350
400
FY92 FY93-94
FY95 FY96 FY97 FY98 FY99 FY00 FY01 FY02 FY03 FY04 FY05
Institutionally BasedProgramsOsteoporosisResearch Program Defense Women'sHealth Res. Prog. National PrionResearch ProgramCooperative DOD/VAMedical Res. Prog.Tuberous SclerosisResearch ProgramMyeloproliferativeDisorders ResearchChronic MyelogenousLeukemia Res. Prog.Ovarian CancerResearch ProgramNeurofibromatosisResearch Program Peer ReviewedMedical Res. Prog.Prostate CancerResearch Program Breast CancerResearch Program
CDMRP Funding History
0
50
100
150
200
250
300
350
400
FY92 FY93-94
FY95 FY96 FY97 FY98 FY99 FY00 FY01 FY02 FY03 FY04 FY05
Institutionally BasedProgramsOsteoporosisResearch Program Defense Women'sHealth Res. Prog. National PrionResearch ProgramCooperative DOD/VAMedical Res. Prog.Tuberous SclerosisResearch ProgramMyeloproliferativeDisorders ResearchChronic MyelogenousLeukemia Res. Prog.Ovarian CancerResearch ProgramNeurofibromatosisResearch Program Peer ReviewedMedical Res. Prog.Prostate CancerResearch Program Breast CancerResearch Program
Awards 26 445 366 313 524 435 661 746 664 726 721 566 ~650
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Training and Research Resources
Innovation-Based Research
ClinicalResearch
Traditional Research(e.g., R01-, P50-type awards)
FY06 Investment Strategy
TranslationalResearch
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Program Cycle
VisionSetting
Release of ProgramAnnouncement
ProposalReceipt
Peer Review
ProgrammaticReview
Candidate Award List
CongressionalAppropriation
Receipt of
Funds
CGApproval Integration
Panel
� Science evaluation� Budget evaluation
� Programmatic relevance� Budget evaluation
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Electronic Proposal/Grant Management
� CDMRP eReceipt System� Web-based proposal submission system
� Includes modules for Principal Investigators and Office of Sponsored Research Representatives
� Information collected in fields, text boxes, and PDF files
� Program and Peer Review Management Information System™ (P²RMIS™)
� Proprietary web-base system owned and used by Constella Health Sciences, our peer review contractor
� Electronic Grants System� Custom designed, state of the art database and business
system for the paperless management of medical research proposals and grants.
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Advantages of Electronic Processes
� Reduced Applicant Cost: Uploading PDF files is less costly than copying and shipping proposal
� Reduced Program Cost: Reduction in labor during receipt and savings in reviewer shipping exceed cost of printing proposal copies
� Increased Communication: Reviewers, Chairperson, and Scientific Research Administrator can review critiques in advance of the meeting
� Time Savings: Compliance (administrative review), referral, and summary statement writing all streamlined through use of web-based tools
� Increased Efficiency: � Allows for collaboration between organizations by implementing
electronic workflows and virtual files
� Allows for real-time data transfer, multiple users, standardization of processes and unprecedented secure access to data
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Standard Peer Review Scoring
Criteria Global Adjectival
10, 9 1.0 - 1.5 Outstanding
8,7 1.6 - 2.0 Excellent
6, 5 2.1 - 2.5 Very good
4,3 2.6 - 3.5 Good
2,1 3.6 - 5.0 Fair
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Regular
(Idea Awards)Concept
Era of Hope
InnovatorClinical Trial Award
Referral Discipline-Focused Discipline-FocusedMechanism-Focused
Mechanism-Focused
Distribution Paper/CD-ROM P²RMIS™ (Web) Paper Paper/CD-ROM
CollectionCritique and Preliminary Scores
Brief Comment and Score
NothingCritique and Preliminary Scores
Pre-MeetingPanel-Wide Access to Comments
None NonePanel-Wide Access to Comments
Meeting Traditional Discussion NoneComparative Discussion
Dual Discussion: Proposal & Protocol
Global Score Numeric: 1.0 – 5.0 Adjectival Only: Outstanding - Fair
NoneSingle Numeric Global Score
Evaluation Criteria
10 – 1 NoneText Only: No Scoring
Separate Criteria for Proposal and Protocol
Summary Statements
Concatenated; Sent to Applicants
Sequential; Internal Use Only
Text Only: No Scoring
Separated Sections for Proposal and Protocol
Peer Review Processes
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Correlations Between Final Global Scores and Final Criteria Scores for Idea Awards
Scores Correlated with Final Global Score
Pearson’s R Correlation
(Interval by Interval)
Research Strategy -0.886
Relevance -0.820
Innovation -0.876
Investigator -0.701
Environment -0.639
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Lessons Learned
� Consumers are integral to peer review
� Efficiencies of cradle to grave electronic management
� Need to maintain dynamic flexible processes
� Tailor peer review processes to:
� Mechanism goals
� Time constraints
� Funding limitations
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Department of Defense Congressionally Directed Medical Research Programs
U.S. Army Medical Research & Materiel Command
Ongoing Challenges
� Identifying Innovation
� Keeping Peer Reviewers engaged during panel discussions
� Congruency among narrative, criteria scores, and global score
� Optimizing panel size, reviewer workload, and length of panel discussion
� Meeting needs of multiple end users of critique
� Programmatic Review
� Applicant