Background: Little evidence exists about what contributes to successful med
ical research, an increasingly important issue in an era of limited researc
h budgets, This study examined predictors of productivity of Swiss medical
research.
Methods: Principal investigators of clinical research projects funded by th
e Swiss National Science Foundation between 1990 and 1994 were surveyed by
mail. They provided information about the research question, whether change
s were made to the protocol and why, their assessment of the importance of
results for science and for public health, and additional funding of the pr
oject. The amount of the grant and the project priority score were obtained
from the Foundation, Indicators of scientific productivity were the number
of peer-reviewed articles and the summed impact factor per grant.
Results: The size of the grant predicted scientific output (number of artic
les and summed impact factor), but the marginal return decreased with the t
otal sum awarded. The award of a continuation grant by the same agency and
additional funding from other sources were also positively linked with prod
uctivity. In addition, the initial priority rating of the project by the fu
nding agency's scientific committee and the assessment of scientific import
ance of the results by the principal investigator mere also independently a
ssociated with productivity. Finally, modifications of the initial research
plan in response to new scientific opportunities were linked with greater
productivity, whereas modifications induced by technical or other difficult
ies were associated with lower productivity.
Conclusions: Productivity in medical research, measured by peer-reviewed ar
ticles produced, requires adequate resources and ability to respond to new
scientific challenges, and it can be anticipated by peer-review.