Presenting at the 2023 Southern Association for Vascular Surgery (SAVS) annual meeting in Rio Grande, Puerto Rico, Amin A. Mirzaie—a pre-medical student at Emory University in Atlanta—offered observations on the National Institutes of Health’s (NIH) “modestly” aligned vascular surgical funding distribution in the context of the current Society for Vascular Surgery (SVS) priorities.
Mirzaie—backed by a senior authorship that includes Samir K. Shah, MD, an assistant professor of surgery at the University of Florida in Gainesville, Florida—began by remarking on contemporary delegation of NIH funding, referring to a “precipitous and slow decline” in public service funding in the period 2006–2016, showing a decrease of 300,000 per year. Yet, during the same time period, he continued, the NIH received a $2 million budget increase, spurring Mirzaie and his fellow authors to investigate the characteristics of “rare” NIH-funded projects granted to vascular surgeon-scientists. They sought to extract the amounts, types and content areas, and determine their alignment with current SVS research questions. Rhetorically setting their research intentions for the audience, Mirzaie asked: “Who is being funded? […] Do funded projects align with SVS priorities?”
Estimating a total of $12 million is awarded to “all active projects,” Mirzaie introduced their methods of investigation, querying the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database for active awards in April 2022. Excluding training awards (T Grants) and for-profit projects, they extracted grant research characteristics in instances which included a vascular surgeon as principal investigator (PI). Additionally, they acquired PI demographic and academic background information through institution profiles.
Identifying 53 active NIH awards given to 40 US vascular surgeon-scientists, and underlining the previously contended rarity of funding, Mirzaie reiterates that “only 1%” are receiving these awards. Continuing, he noted funded vascular surgeon-scientists are an average of 15.9 years out of training, with 37.5% being women—which Mirzaie alludes to being “much higher” than other sub-specialties—contending this shows “strong signs” for more frequent female NIH funding allocation.
Bringing the focus to the intersection between NIH and SVS research priorities, Mirzaie posed that eight out of 53 active projects given to vascular surgeon-scientists “directly addressed” any SVS primacies. Continuing, he noted that four SVS priorities included in the most recent 2021 refresh, were not “fulfilled by any NIH projects.”
Among active NIH projects, Mirzaie points out that 77.4%—the largest group assigned funding—have been awarded, or “skewed” he noted, to basic/translational research studies, while 22.6% are clinical/health services research projects. Abdominal aortic aneurysm (AAA) and peripheral arterial disease (PAD) are the most commonly funded disease areas, accounting for 56% of projects. Mirzaie also added that 15% of the NIH-funded projects meet one of the ten clinical research priorities defined by the SVS.
“Moving forward this shows that we need more funded vascular surgeons and better coverage of SVS priorities,” said Mirzaie, solidifying his observations for the audience. Recognizing that NIH funding is “complex,” he proposed multi-specialty schemes collaborating with the SVS could “create better training programs, respective grant holders, and funding institutes” to accurately address their overall priorities.
Of Mirzaei’s concluding thoughts at SAVS, emphasis was placed most particularly on ensuring future NIH-funded projects answer important clinical questions posed by the SVS, as well as on how their data can be employed to “reassess and reconsider current strategies” to produce future vascular surgeon scientists.