# A formal patient-burden score in grant peer review

Source: https://onco.cc/ideas/idea-fund-patient-burden-review-criterion/  
OnCo record `idea-fund-patient-burden-review-criterion` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Add a scored criterion to grant review that asks how much suffering the proposal addresses and how soon, judged partly by patients, and give it real weight.

## Summary

Peer review currently scores significance, innovation and approach, which reward novelty and technical elegance. A burden criterion (deaths, DALYs and unmet need in the target population, plausible time to patient impact) is scored separately by a panel that includes trained patient reviewers and carries 20% of the total. The Patient-Centered Outcomes Research Institute and the US Department of Defense cancer programmes already include consumer reviewers; this makes burden an explicit, weighted term.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Introducing a 20% burden criterion shifts the funded portfolio towards high-burden, near-term questions within two cycles without lowering the mean scientific quality score of funded awards.
- Rationale: Where consumer reviewers sit on panels (DoD CDMRP, PCORI) funded portfolios differ measurably from science-only panels, and investigators report designing more patient-relevant studies. Explicit weights are needed because informal patient input is discounted when it conflicts with scientific enthusiasm.
- Proposed test: Score one review round twice, with and without the burden criterion, and compare the two hypothetical funded sets on burden alignment and scientific score; then run it live for a cycle.
- Maturity: speculative
- Actor: policy

## Sources

- CDMRP (US DoD medical research programmes): https://cdmrp.health.mil/

## Connected records

- ideas: [Burden-weighted portfolio targets for every major cancer funder](https://onco.cc/ideas/idea-fund-burden-weighted-portfolio/), [Patient-held portable consent for reusing samples and data across studies](https://onco.cc/ideas/idea-fund-portable-patient-consent/)
- bottlenecks: [Funding follows fashion, not burden](https://onco.cc/bottlenecks/b-funding-allocation/), [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/)

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