Why OIG Did This Review. Congress, the National Institutes of Health (NIH), and others have raised concerns about the integrity of U.S. medical research. In August 2018, the NIH Director stated that the risks to the integrity of peer review were increasing. Subsequently, Congress provided the Office of Inspector General with $5 million for oversight of NIH. Peer review is how NIH uses scientific experts to evaluate grant applications for funding. This study assesses the extent to which select NIH institutes and centers (ICs) met NIH’s requirements for documenting first-level peer review when evaluating applications for grants for extramural research, and the extent to which ICs made funding decisions that were not strictly limited to the scores from the initial scientific review (i.e., the extent of funding grant applications out of rank order). NIH’s peer review process is central to its upholding its values of transparency, impartiality, and fairness, among others. Therfore, it is important for NIH to ensure that the process works as intended. How OIG Did This Review. We reviewed a representative sample of extramural grants funded by six ICs in fiscal year (FY) 2018. For those grants, we assessed NIH’s compliance with selected aspects of its peer review process. We did so by reviewing summary statements, documentation of NIH’s followup to resolve peer reviewer concerns, and justifications for funding grants out of rank order. We also reviewed the Department of Health and Human Services’ (HHS’s) grant policy, NIH policies, and NIH’s written responses to our questions.
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