October15, 1999
Ellie Ehrenfeld, Ph.D. Director Center for Scientific Review 6701 Rockledge Drive National Institutes of Health Bethesda, Maryland 20892
Dear Dr. Ehrenfeld:
This letter is written on behalf of the Consortium of Social Science Associations (COSSA), the American Anthropological Association (AAA), the American Psychological Association (APA), the American Sociological Association (ASA) and members of the Health and Behavior Alliance in response to your request for comments by October 15, 1999 on the Center for Scientific Review (CSR) Panel on Scientific Boundaries Report.
We appreciate the intent of the Panel to develop a more cohesive and integrated peer review system at the National Institutes of Health (NIH) and the time and effort expended to do so. We offer these comments as a means of assisting the Panel in accomplishing its objective, particularly that of advancing health-related scientific research at NIH.
As organizations representing the social and behavioral sciences, we appreciate the advances that NIH has made in broadening its research portfolio. NIH has given increased attention to the role that social and behavioral factors play in the promotion of health and the prevention and treatment of disease. The establishment of the Office of Behavioral and Social Sciences Research (OBSSR) and the NIH Director's interest in understanding and eliminating disparities in health among ethnic minority populations, women and the medically underserved are just two visible examples of this evolution taking place at NIH. We applaud and encourage NIH in these endeavors.
Recommendations
Recommendation 1. We recommend that the Panel use the phrase "biomedical, behavioral and social" sciences or research wherever the term "biomedical" science or research appears. Alternatively, the Panel may consider using the term "health-related" sciences or research wherever the term "biomedical" sciences or research appears. In this case, "health-related" sciences or research would need to be defined to include the range of sciences or research, including social and behavioral sciences, supported by NIH.
Accordingly, the Panel may be unaware of how the language of the Boundaries Report appears to limit the range of research supported now and in the future by NIH. By using, almost exclusively, the term "biomedical sciences" or "biomedical research," the Report gives the impression that NIH is narrowing its focus and support only to the biological, medical, and physical sciences. If this is true, it signals a turn from the positive direction in which NIH has been moving and will prove to be a major loss for the health of the Nation.
Recommendation 2. We recommend that the Panel strike the terms "bench" and "bedside" from the Report and use the terms "applied" and "basic." Although the differences between applied and basic research are sometimes difficult to discern, the latter language is more inclusive than the former, with its images of microscopes and physicians.
We ask the Panel to reconsider the use of the terms "bench" and "bedside" in the Report. While the terms appear to be used to distinguish "basic" from "applied" research, the implications are that only biological laboratory science and clinical practice are within the purview of NIH. The expressions appear to preclude research done in other settings such as field research conducted in the context of communities or human populations. We agree, however, with the Panel's goal of having basic and applied science reviewed in the same IRG (page 5).
Recommendation 3: We recommend that the Panel substitute the following sentence (page 5, paragraph 2) to read: "Our Panel recommends the following 21 IRGs, beginning with the first 8 that emphasize biological, social and behavioral processes, and followed by 13 that are structured to apply that knowledge to specific diseases or organ systems."
In recommending the 21 proposed Integrated Review Groups (IRGs), the Panel stated that the first five "are concerned with the fundamental biological processes or technologies . . . " (page 5). We are troubled, however, that the report does not acknowledge basic social and behavioral sciences research. It could be inferred from the report that the committee considers all behavioral and social sciences research to be applied in nature. In our view, the first eight proposed IRGs involve fundamental processes that underlie disease and organ systems, since IRGs 6, 7, and 8 include a substantial amount of fundamental research. We ask the Panel to consider alternative language for this sentence.
Recommendation 4. We recommend that the proposed IRG 8 title in the Report be struck, and be titled "Bio- and Socio-behavioral Processes IRG," or alternatively, "Social, Behavioral and Biobehavioral Processes."
Proposed IRG 8 is entitled "Behavioral and Biobehavioral Processes." Yet, social and cultural processes related to interpersonal behavior, language, and cognition are considered within this IRG.
Recommendation 5. We recommend that the term "behavior" in proposed IRG 6 be struck, so that the description of the Health of the Population IRG reads, "This IRG will consider research applications focused on broad social, environmental, cultural and other contextual influences on health."
The Report ties IRG 6, Health of the Population, to research influencing "health behavior." As written, the description would appear to limit social science research funded through this IRG to that focused on health behavior. However, a good deal of social science research goes beyond behavior to better understand the social contexts that help promote good health or increase the likelihood of disease. For example, social and cultural research may be designed to understand why some populations and individuals successfully overcome disease while others do not.
Recommendation 6. We recommend that in recognition of the very recent reorganization of the behavioral and social science IRGs, that the Boundaries Report explicitly state that these IRGs and their study sections be kept in place for three to five years, aside from minor changes that may be necessary as the IRGs are evaluated.
The Panel was convened, and the Boundaries Report issued, just as some existing IRGs have been reorganized at NIH. Our organizations and others commented at this time last year on the reorganization of three of these IRGs: Behavioral and Biobehavioral Processes; Risk, Prevention and Health Behavior; and Social Sciences, Nursing, Epidemiology and Methods. A footnote in the Boundaries Report mentions that the newly reorganized behavioral and social science IRGs are being kept as they are for now. However, given the significant input from the scientific stakeholders, and the number of new hires in CSR to manage them, we hope to be reassured: How, and for how long, does the Panel's proposed reorganization expect to preserve the reorganized IRGs?
Recommendation 7. We recommend that the committee grandfather the HIV/AIDS IRG and give it a fixed term, such as three to five years, after which its existence could be reevaluated.
Our colleagues who conduct behavioral and social sciences research on HIV/AIDS have voiced their concerns regarding the proposed dissolution of HIV/AIDS IRG. Again, with a great deal of input from the scientific stakeholders, this IRG was recently reorganized, and most believe that AIDS grant review is not broken.
External Advisory Committees. We appreciate and approve the Panel's intention to add an external advisory committee to each IRG. This would assist in broadening the expertise and range of thinking of the IRGs.
Social and Behavioral Science Expertise. Finally, we suggest to the Panel that there needs to be a mechanism to incorporate the expertise of social and behavioral scientists in the review of research applications to the proposed disease and organ-related IRGs (9-21). Investigators whose projects are applied and disease-specific may in some cases prefer review in those IRGs. Certainly the trend toward multidisciplinary research proposals would seem to require that applied research with sub projects or portions of projects that are behavioral or social in nature will need expanded review in the disease-or-organ IRGs. This may be an issue at the study section level, and we encourage your attention to it as the Committee turns its consideration beyond the IRG level.
Again, we appreciate the opportunity to provide comments on the Boundaries report. Please contact us if we may provide additional information, or if we can assist the Panel in any way.
Howard J. Silver, Ph.D. Executive Director Consortium of Social Science Associations
Mary Margaret Overbey, Ph.D. Director, Government Relations American Anthropological Association
Richard McCarty, Ph.D. Executive Director for Science American Psychological Association
Felice J. Levine, Ph.D. Executive Officer American Sociological Association
Margaret Chesney, Ph.D. Past President Academy f Behavioral Medicine Research
Oakley Ray, Ph.D. Executive Secretary American College of Neuropsychopharmacology
Stewart Fleishman, MD American Society for Psychosocial and Behavioral Oncology/AIDS
Angele M. McGrady, Ph.D. Association for Applied Psychophysiology and Biofeedback
Jessie Gruman, Ph.D. Executive Director Center for the Advancement of Health
Arlan G. Richardson, Ph.D. President Gerontological Society of America
Center for Scientific Review Panel on Scientific Boundaries for Review
Panel on Scientific Boundaries for Review, Update, January 10, 2000