Problems of sub-infra-under-disciplines

Feb 03 2017 Published by under Uncategorized

Most of us do research that is "trans-disciplinary" or "integrative" in one form or another. In fact, I have always touted that as one of the secrets to getting NIH funding: the careful design of a project that is of interest and importance to your IC's missions/goals, but will still answer the fundamental questions you think are important and gripping. For various folks from my background (evolutionary/ organismic/ ecologic), this is one path to NIH funding.

My NIH-identity does not easily fall into any IC. It's a disease, but one that doesn't have its own IC, like deafness or cancer, or even part of one, like stroke. It's not a well-defined clinician entity, with a large, sub-group, like dentistry or nursing. It's across the agespan, so it's not like Alzheimer's, which is largely a problem of the elderly, or prematurity, which is largely assigned to peds. The fact is nobody wants to fund my particular version of bunny hopping. They have said so explicitly, despite it being a major cause of morbidity and mortality for a number of other significant diseases.

This is very evident in that proposals get bounced around in terms of IC assignment. My poor postdoc in particular got told not to bother to submit the K-award by IC-one, because we're not funding that, any more, and IC-2 said try IC-1, because they do that and not us, and IC-3 never even answered the emails. Time to revise and resubmit.

The response of various people, people in this sub discipline, to this problem is very interesting, in part because of the different perceptions of "why" and what the problem really is.

I have my views. Of course I do.  I think historically this has been a "women's field", like nursing, where most of the clinical practioners were women.Over the  years there has been a lot of lip service to "interdisciplinary" teams, and this may have been true for the folks working with patients But it has not been reflected in attendance at meetings and publications in the flagship journal. Interestingly to me, at least, is that European and Asian societies are more diverse, in terms of discipline, and are much larger. That is, 5000 people at the meeting instead of 500. But that's not where the funding is.

A second problem is, in my view, but with some evidence, that through the 90's and 00's IC#1 (from above) funded a lot of work in this field. A lot of very bad work. Big clinical trials that were ultimately flawed or produced only negative results. Part of the reason for this, in my view, is that they were treating symptoms and not looking for mechanism. This was at a time, when NIH was shifting to mechanism and pathophysiology. At one point, a couple of years ago, one of the PO's from IC#1 basically said this to me, when I was on an in-house study section.

[As an aside, I know lots of people who "went over the PO's head" to absolutely no effect at all. In this case].

SO what is the response of the folks in this area to this problem? There have been two very distinct responses, that I have seen. One might chose to categorize them as Old- and Young- guard. But there are young 'uns in the old camp.

The old guard write editorials in the journal, and Talk Seriously About the Problem at the National Meeting. I seldom am invited to participate in these, because, after all, I am not a clinician. These people cling to their clinical status and research justification. And I work on animal models. (Aside, this is a meeting where I have been criticized for "pretending" that my animal models are relevant, because animal models not have compliance issues, or co-morbidity concerns. Explaining ceteris parabis to these people did not and will not work). But I read what they write and shake my head. Lots of self-pity, lots of "we need PR". Very little introspection as to what has been done wrong.

There is an anniversary divisible by 10 of the journal, and they commissioned a number of articles. Here, to me, is a reflection of the problem. I was asked to write "about animal models". Not about the questions of mechanism I have been working on. Not about the underlying scientific/ neurological/ physiological/ biochemical problems that I address with animal model models. I wrote the article as a plea for understanding pathophysiology and mechanism. You could take out my disease name, and put in "blindness" or "cancer" or "ALS" and it would be entirely relevant (although you'd need new references).

On the other hand, the young turk's response struck me as, well, incredible. Incredible in a wonderful way. Two young, one just pre-tenure, and one just post-tenure, organized a small local meeting. 20-25 people. I was flattered to be invited, and two other olde fartes were there. Everyone else was in spitting distance of their postdoc/residency. Lots of students there, too.

We got the agenda a few weeks in advance. The meeting was NOT presentations by anyone, although you could bring slides on a computer to support points. There were 1-2 major question in each morning or afternoon block, that were starting points. What is the definition of our clinical problem? In terms of physiology, in terms of patients? What is good and bad about how we look at it clinically? What do we need to do to understand this problem? What are the other problems that need to be addressed that we've not thought about? Two intensive days. It was incredible. What do we need to do and how can we best do it? I felt like I contributed to thinking about how to do research, and importantly, came back charged up thinking about what my work means and does and how to make it better. That meeting certainly informed my article about the role of animal research.

The Big National Meeting of this group always seems to me the same people saying the same things. It's small for A Big National Meeting, 400-600 people, of whom <150 present info. One session, everybody there. I have not been excited at this meeting for years. In fact, I'm not going to go this year. I send my trainees (who almost always get to present) and who have a good professional experience. Most of the young turks from the small local meeting will be there, and they are tremendously kind, professionally, to various younger trainees who show up.

But, there are always young people willing to sell their soul for a mess of pottage. The current president of the society is young and should be a rabble rouser and agent of change. He should be part of the Young Turk Group. But he's a physician who has morphed into an old man and espouses the party line.

I judge this group's ability to change the course of NIH funding priorities as small. But the young group? They are understand what research is, what modern, current, NIH priority research is. They are funded, and in fact, they are the ones who will be making a difference in the world, for the patients, for our understanding.

 

5 responses so far

  • girlparts says:

    Fascinating. The same tug of war is evident in my field. Perhaps this is universal in biomedical research? The NICHD recently released a report "Funding the Best Science" asking why the payline is so low. While NIH overall is ~35% human studies, NICHD is more like 65% human studies. And while the size of R01 for animal studies is in line with the rest of the NIH, the human studies are more expensive on average. On top of that, large clinicalnetworks account for 25% of the agency's extramural funding. A few years ago, people in my generally NICHD-funded field were extremely excited to see our area recognized as a priority, and money directed at it, only to find that all the RFAs are limited to human subjects, and expressly forbid research that looks at pathophysiology. It's all biomarkers and noninvasive imaging and shit. (I think that RFAs that dictates means/methods instead of goals are a bad idea anyway, but that's a different discussion)

    • EPJ says:

      I really encourage the science community to start looking at a few short videos in youtube that describe the way money comes into the world system and is distributed (secret of oz, or other short cartoons). And I mean to be helpful in terms of contributing ideas for solutions rather than to create more problems. And to reduce the tug(s) of war everywhere, and precisely where least needed or wanted.

      The videos kind of like explain a core idea that best illustrate a 'cause effect' relationship', but applied to the complex system that is society, and add to that complexity the increase in number of participants. But here is a key point, is man-made and somehow those conditions do not fit the current world conditions, so man should change those parameters to be best fitting.

      Does it explains the situation in science and medicine? at least some of it. And it has not much to do with effort, cleverness, or even fitting ideas or ideals.

      It has become a predictable life, wars, not favorable to at least some of the best trait that have made humans successful and special among so many species in the planet.

      Thanks for reading this.

  • EPJ says:

    Potnia,

    as I understand it, all types of lab/in vitro systems have been worked into the science research system to understand the biological mechanisms normally in place, and they are there to be used before going into clinical trials with humans to test a medicine or therapy, as well as for comparative analysis. At least that should be the better approach, any other events likely reflect exhaustion of resources, like money, or even human thinking. So again, I insist that the rate limiting step is mostly money, and further say that it has consequences on human health and thinking.

    So money systems are a must to improve, and job systems need expansion, but decreasing the things in the way to a better life, in quality and quantity.

    Also, lots of excess animal systems have been already trimmed to the minimum needed, and resources are shared in several ways. So that part is already improved, and people need to be aware that that success reflects the hard work of previous generation of scientists and good contribution to the many fields.

    Non-human work continuous to be needed, otherwise people move directly into human experimentation, and that is always big problem. The problem the health care system complaints about is the rush to develop cures. But then you wonder why is it that health problems are increasing? is it more disclosure or something else?

    Basic science is needed for many reason, and clinical research is the ideal cooperating partner. But health runs into problems when it becomes one of the main pillars of businesses and money making.

    One true breakthrough of the 21st is the realization that humans came up with money and economy, so humans can change it for true progress of humanity and for developing a much better society. I say via useful work activities rather than welfare that creates dependency.

    • potnia theron says:

      I think another part of this issue is the headlong rush towards "reductionism". Back in the day, it used to be that scientists thought that if we knew the genes for a disease, that would be that, and it would be all solved. Now we know that even as we understand cellular --> molecular --> genes, that there are epigenetic processes. But the idea of "emergent properties" (I think I blogged about this back when I was with Mama Isis) clearly holds both for normal physiology and for abnormal/patho-physiology.

      One of the most important lessons from one of my mentors was/is "absent knowledge of normal, understanding, diagnosis, and cure for abnormal is impossible". You can ameliorate symptoms, but curing requires basic knowledge and understanding.

      • EPJ says:

        Yes, agree with mentor approach to produce a cure, because if you figure out the functions and interactions of molecules/genes, which also describe the mechanism for a certain organ/tissue to work properly, you can make predictions as to what would happen to the organism under certain conditions. That part is then correlated with symptoms, the clinical aspect of health, and the more reliable diagnosis depends on both aspects contrasted. That is how I see it.

        There's then the obvious differences between individuals and the different groups, and the changes through time for a specific reason. But people come with all kinds of justifications to end up in the same 'fight', which is obviously self-defeating

        Maybe that is "the clincher", I've come to think of it as 'the 8th ball' approach of sustainability.

        What a strange world this is.

Leave a Reply