UROLOGY PEER-REVIEW AT THE NATIONAL-INSTITUTES-OF-HEALTH

Purpose: Urology is a field with many subspecialties and, as a consequ ence, urological research grant applications are distributed to a vari ety of different study sections at the National Institutes of Health ( NIH). It has long been the conviction of urological investigators that urological grant funding suffers as a result of this distribution. We investigated the composition of these study sections to identify the prevalence of urological expertise (or lack; thereof). The review chal lenges the concept that urological research grant applications are bei ng subjected to adequate peer review. Materials and Methods: Aided by personnel from the National Institute for Diabetes, and Digestive and Kidney Diseases, and the National Cancer Institute, 22 study sections to which urological grants are distributed were identified. A 3 to 5-y ear retrospective MEDLINE analysis of all the scientific publications of-each study section member was done. Urological experts were identif ied by the criterion of having more than 1 urological publication publ ished per year or a proportional equivalent. An equivalent analysis wa s performed for the study sections reviewing cardiology grants to serv e as a comparison. Results: Data analysis revealed that only 12 of 351 study section members reviewing urological grants are urological expe rts (3.4%). Only 3.1% of the collective published productivity of thes e members is in the broadly defined field of urological investigation. Omitting the published productivity of these 12 experts, less than 1% of the published works of the remaining 339 members reflects interest or expertise in urological investigations. Of the 22 study sections o nly 8 have urological expertise represented in their membership. Excep t for 1 study section, representation of urological experts was usuall y limited to 1 individual reflecting a 5.9 to 11.1% minority in these study sections. Conclusions: The lack of urological expertise represen ted on the NIH study sections reviewing basic and clinical urological research grant applications has far reaching ramifications. Consequent ly, grant applications on genitourinary diseases that commonly afflict a preponderance of Americans are inadequately reviewed at the NIH. On ly through the provision of appropriate peer reviewers will this probl em be solved.