OnCo
ideasIdea

A formal patient-burden score in grant peer review

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.

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.

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.
What would test it
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
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks

Connected

4top