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Public Consultation on the NHMRC Draft Principles of Peer Review submission

ID: 
14
This submission reflects the views of
Organisation Name: 
Arthritis Australia and the Australian Rhuematology Assocn
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Non-Government Organisation
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Joint Submission from Arthritis Australia and

the Australian Rheumatology Association

 

About Arthritis Australia

Arthritis Australia is the peak arthritis organisation in Australia and is supported by affiliate offices in every state and territory.  

Arthritis Australia provides support and information to people with arthritis as well as their family and friends.  It promotes awareness of the challenges facing people with arthritis across the community, and advocates on behalf of consumers to leaders in business, industry and government.

In addition, Arthritis Australia funds research into potential causes and possible cures as well as better ways to live with the disease.

About the Australian Rheumatology Association

The Australian Rheumatology Association (ARA) is the Special Society within the Royal Australasian College of Physicians (RACP) that represents Rheumatologists. The ARA supports and educates members and other practitioners in the musculoskeletal field to enable provision of best possible management for patients. It fosters excellence in the diagnosis and management of musculoskeletal and inflammatory conditions through training, professional development, research and advocacy.

The ARA has long recognised the importance of medical research in delivering excellence in clinical care and has strongly supported and promoted research activities. The ARA Annual Scientific Meeting (ASM) is the key event on the rheumatology calendar providing an important forum for education and dissemination of research findings. The ASM profits go directly to the ARA Research Trust to support rheumatology research through fellowships, scholarships and grants administered by Arthritis Australia and the RACP.

 

INTRODUCTION

Arthritis Australia and the Australian Rheumatology Association welcome the opportunity to provide comment on the draft NHMRC Principles of Peer Review.

We commend the NHMRC on developing these draft principles for consultation because they will assist in improving transparency and accountability in allocating funding for health and medical research.  We also generally support the principles, as outlined, subject to the comments provided below.

We note however that good principles need to be underpinned by good practices, including clear and transparent policies, procedures and guidelines to safeguard the integrity and fairness of the peer review process. Once this consultation is completed, an audit or review of existing policies, procedures and guidelines around the peer review process is recommended to ensure that they support the agreed final principles.

PRINCIPLES

One principle which appears to have been overlooked in the draft principles is excellence. This is relevant both in terms of identifying research excellence for funding purposes and excellence in the peer review process itself.  The principle of excellence is partly captured in “continuous improvement” but this seems less of a principle than a description of a process whereby excellence can be achieved.

Fairness

We support this principle.

In particular, it is very important to ensure that applications are assessed by individuals who have appropriate expertise and knowledge in the fields covered in the application.  While this may be difficult to achieve, given the number of applications that are received and the spread of fields encompassed, it is crucial to ensuring that an application is appropriately and fairly assessed.

Transparency

Transparency is an essential principle as it goes hand in hand with accountability and is essential to allow adherence to the other principles to be assessed. 

One aspect of transparency which is not covered in the current draft is the provision of adequate feedback to applicants on the assessment of their research proposal, especially at grant review panel level. This is important for applicants to address any deficiencies in their grant application which need to be addressed prior to the next round of grant submissions. While feedback is provided to applicants as a result of the peer review process, the feedback given to applicants after the grant review panels have assessed grants and made a decision about funding is often minimal and rarely of any use to the applicants in improving their grant when they resubmit the application in a subsequent funding round.  

Independence

We support this principle.

Appropriateness and balance

The composition of grant review panels and the extent to which they have the appropriate expertise to assess the applications they are reviewing is of critical importance in ensuring a fair and effective peer review system.

Researchers in the field of musculoskeletal conditions have highlighted issues relating to the composition of grant review panels with the NHMRC in the past.[i]  These issues included the allocation of grant applications in rheumatology to panels with no rheumatology expertise while panels with rheumatologists received few arthritis-related applications. 

There is also a view that expertise on grant review panels is skewed towards basic science, to the detriment of clinical expertise. 

A review of the process used to match the profile of reviewers to the grants being assessed may be appropriate.

Research community participation

This principle, as described, implies that the onus is on reviewers to familiarise themselves with NHMRC’s policies and procedures, but NHMRC could take a more proactive approach to this with a more extensive induction and/or training process for reviewers.

Confidentiality

We support this principle.

Impartiality

Impartiality is an important principle for the peer review process but can sometimes be at odds with ensuring that the most appropriate expertise is available to review applications, because of conflict of interest issues. 

While protecting against conflict of interest is important, review by peers is one of the core pillars of NHMRC grant assessment processes and should be a minimum expectation. In fields such as musculoskeletal research, where the research community is relatively small and most reviewers are likely to have some links to an applicant, conflict of interest processes can create challenges in ensuring appropriate expertise is available to review applications.  

At present, management of conflicts of interest on grant review panels is black and white with anyone with a potential conflict required to absent themselves from discussions on the application in question. However, it may be possible to manage or mitigate conflicts of interest without excluding a reviewer completely where the appropriate expertise on a panel is otherwise limited. For example, depending on the nature of the conflict, it may be appropriate for the conflicted reviewer to participate in discussions, or answer questions on technical matters, but absent themselves from final scoring of an application, or an international expert could be included in the review process.  Policies or procedures could be developed to provide guidance to reviewers and panels in these situations.

Continuous improvement

We support this principle, but suggest, as noted above, that “Excellence” may be a better principle than “continuous improvement” as the latter is the process whereby excellence is achieved.

ASSESSMENT CRITERIA

As outlined in our submission to the Review of Health and Medical Research in Australia,[ii] Arthritis Australia and the Australian Rheumatology Association consider that a significant component of  health and medical research funding in Australia should be more strategic and priority driven.  In particular we consider that more should be done to support research in the nine National Health Priority Areas (NHPAs) established by the government, of which arthritis and musculoskeletal conditions is one.  In our submission we called for clearly articulated research funding mechanisms to support identified NHPAs, including dedicated Centres of Research Excellence, dedicated funding streams, support to build research capacity and targeted calls for research by the NHMRC. 

NHMRC peer review processes should also support a more strategic approach to funding health and medical research by giving additional weight to applications which address the NHPAs or other identified priorities.  The current selection criteria for NHMRC project grants require consideration of  the scientific quality of the research proposal, its significance and/or innovation and the track record of the research team. While these criteria are important and relevant they do not support a more strategic approach to government funded health and medical research.  Additional assessment criteria to assess an application’s relevance to NHPAs or other strategic research priorities should be included the peer review process.  Given the large number of quality applications that go unfunded each year, this could be done without compromising research quality.

Additional weight should also be given to applications which address important medical problems with the potential to have an immediate impact on the quality or efficacy of medical care.

A more strategic approach to research funding would provide better returns to the government on its investment in health and medical research by targeting the conditions that create the heaviest disease burden on Australians.




[i] Letter from G Jones and R Mason to W Anderson, 9 September 2011.

Page reviewed: 19 February, 2013