Introduction: Characteristics of academic neurosurgery departments that secure high levels of extramural funding remain unclear. This study explores correlates with NIH funding to identify factors that may encourage funding growth.

Methods: Data were obtained from responses to a survey of ACGME-approved neurosurgery programs conducted by the CNS Research Committee during 2008 with 60 (62%) of 97 programs responding. Surveys meeting inclusion criteria (n=53), department websites, Ponze and Lozano’s highly-cited neurosurgery publication lists, and U.S. News & World Report were used to gather data regarding research/grant revenue, department personnel/achievement, faculty educational backgrounds, participation on NIH study sections, residency training program data and hospital rankings. Statistical analysis included simple correlation using Kendall’s Tau, and Kruskal-Wallis tiered analyses to compare groups of institutions ranked by NIH funding and then separated based on both (1) quartiles and (2) natural gaps in earnings.

Results: Across all three analyses, NIH funding was correlated with NIH-K awards, total residents, and resident research time (p<0.05), along with non-neurosurgeon independent investigators, PhD faculty, NIH study-section membership, and faculty conducting basic-science research (p<0.01). Though correlated across tiers (p<0.01), top-cited literature publications and neurosurgeon clinical investigators were not greatest for the top four institutions by research revenue. Neither hospital rank nor presence of research vice-chairs was significantly correlated.

Conclusions: This survey review identified several correlations. Faculty educational background (PhD degree), faculty involved with basic science, research personnel and achievement (non-neurosurgeon independent investigators; NIH study section membership; NIH K awards), and residency characteristics (total residents; resident research months) were found to correlate with academic neurosurgery programs securing the greatest extramural funding.

Patient Care: Academic neurosurgery is charged with advancing the specialty by creating innovation, driving evidence-based care, and maximizing patient outcomes and quality of patient care, in large part through the publication of rigorous, peer-reviewed, scholarly research in the neurosurgical primary literature. In these economically challenging times, success will require academic neurosurgery departments to not only maintain, but grow their NIH and non-NIH extramural research funding, particularly difficult given the tightening payer environment. Exacerbating this challenge is the fact that i) the NIH budget in recent years has decreased in inflation adjusted dollars; ii) NIH funding has been shown to be concentrated typically in medicine and psychiatry departments [Ozomaro]; and iii) there are many well described factors that may deter neurosurgeon clinician scientists from entering academic research practices [Friedlander, Zusman]. In their 2005 paper, Itagaki et. al. showed that an academic radiology department's NIH funding is highly correlated with the aggregate number of papers published and the impact factor of these papers. Herein further factors are explored. Correlates with NIH funding are explored to provide the leaders of academic neurosurgery departments with data about actions they may consider to strategically position their departments to grow extramural funding, critical to the research necessary for patient care advancement.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Determine and describe the importance of general trends correlated with NIH research funding for neurosurgery programs 2) Discuss, in small groups, the specific characteristics of academic neurosurgery programs that secure the most extramural funding 3) Identify data applicable to strategic decision-making for leaders of academic neurosurgery departments

References: Friedlander RM. The Perfect Storm: Current Status of Research in Neurosurgery. Congress Quarterly. 2008; 9(1):38-41. Itagaki MW, Spellman JP, et al. Factors associated with academic radiology research productivity. Radiology 2005; 237:774-780. Ozomaro U, Gutierrez JC, Byrne MM, Zimmers TA, Koniaris LG. How Important Is the Contribution of Surgical Specialties to a Medical School’s NIH Funding? Journal of Surgical Research 2007; 1:16-21. Ponce FA, Lozano AM: Highly cited works in neurosurgery. Part I: the 100 top-cited papers in neurosurgical journals and Part II: the citation classics. A review. J Neurosurg. 2010; 112:223–246. U.S.News & World Report. Best Hospitals. http://health.usnews.com/best-hospitals. Zusman E, Rosen C, Stroink A, Heary R, Jacobs P, McKallip D. CSNS Report on Socioeconomics of Neurosurgical Research Ad Hoc Committee on Socioeconomics of Neurosurgical Research. April 2009.