I got a check from the Department of Defense that represents Your Tax Dollars At Work.  You paid for me to recommend where some of that defense money goes.  I tried my best, and I hope you’re happy with my performance.

Whatever your opinions or political leanings, I think we all agree that the effects of war on our warriors and their families is tremendous.  And we hear stories how returning soldiers and veterans don’t receive the best possible care.

Let me tell you about some of the medical research being funded.  Real research and development projects aimed directly at the most significant medical problems.  A huge new challenge is dealing with IEDs - Improvised Explosive Devices - causing blast injuries.  Those who survive often suffer lost limbs, traumatic brain injury, PTSD.

I’d like to tell you about where the money is going, and how the government decides to spend it.

Congressional Programs

The government has several Congressionally-Mandated programs, one of which is called the Applied Research and Advanced Technology Development Awards (ARATDA) of the Defense Medical Research and Development Program (DMRDP).

A mouthful, I know.

These are proposals for medical R&D directed specifically at the effects of war on our warriors.  Stuff from basic research to repair spinal cord injuries to robotic systems for rehabilitation to “smart” prosthetics.

I’m sure you’ve heard how expensive a high-end prosthesis can be, but some proposals are to create low cost devices, not just really smart and expensive ones.

The goal of the DMRDP is to advance the state of medical science in those areas of most pressing need and relevance to today’s battlefield experience, for example in the areas of psychological health and traumatic brain injury (TBI).

The objectives of the DMRDP are to discover and explore innovative approaches to protect, support, and advance the health and welfare of military personnel, families, and communities; to accelerate the transition of medical technologies into deployed products; and to accelerate the translation of advances in knowledge into new standards of care for injury prevention, treatment of casualties, rehabilitation, and training systems that can be applied in theater or in the clinical facilities of the Military Health System (MHS).

Pretty impressive stuff.

How proposals are selected for funding

No doubt you’ve heard about all these special interest, political, backroom contracts, pork projects, grants and deals.  Don’t consider all of them suspect - the government funds thousands of terrific projects.

And how do they choose which projects to fund?  Many are selected by peer-review panels - cross-functional groups of researchers, clinicians, folks from industry, etc.

These folks are assigned several proposals within their areas of expertise, and are expected to read, review, verify, rip apart, and grade each one.  And write up formal reviews.  Then everyone gathers in a closed room and debates the pros and cons of each proposal.

I was invited to be a peer reviewer for these grants.  And for several, the top scientific reviewer.  Each proposal must be very explicit in what they intend do to, how they intend to do it, why it’s relevant, how long each little step will take, and how much it will cost.

I spent about 20 days for detailed engineering and technical analysis of these proposals. This could mean analyzing the submitter’s engineering analysis of a new technology at the level of a circuit or a chemical reaction.  Doing statistics to make sure they will test on the right number of subjects.  Digging through detailed budgets to see where every dollar would go.  Checking the background and expertise of every person on the proposal.  Evaluating detailed project plans to see if the work proposed is actually doable on time and within budget.

The Panel Review

A review panel meeting looks just like the picture above.  Everyone was assigned a seat, a computer, and a microphone.  I met with over a hundred experts in their fields in our nation’s capital to debate the pros and cons of these proposals.  Sometimes my analysis hit the mark and convinced the panel, and other times I recognized others had analyses I hadn’t considered.  Or didn’t have the background to consider.  We debated, we summarized and we went on.

But here’s something I didn’t expect - in addition to all the “experts,” significant input and scoring came from “customers” … those folks directly impacted by the war, and who could directly address the relevance and impact of each proposal.  Soldiers.  Family members of those at war.  Veterans.  One panel member was a soldier calling into the conference from Iraq. To tell *us* - the “experts” if a proposal was really useful, or if it just *sounded* useful.

How much more relevant can you be?

And you know what?  It was completely collegial and professional, and I saw no evidence of politics or favoritism.  It was all about the grants - the quality of the work proposed, and the impact on our soldiers and families.  I was impressed how reviewers can focus purely on the proposed research and assign numerical scores in many categories.  And back up these assessments with solid justifications.

Why did they pick me?

I haven’t reviewed grants for a couple years, but in January I was contacted by a representative who admitted he had to “track me down over several years and companies” to get a valid email address.

I was impressed, and I think you should also be impressed how hard they worked to find people who had just the right background to review these particular proposals.  I happened to have the ideal background - biomedical engineering PhD, traumatic brain injury, measuring physical and cognitive human performance - and they expended some serious time locating me.  No doubt the others on the panel were also chosen so selectively.

Is this is government stereotype we have?

So what did I get out of it?

Sure I got paid.  But it wasn’t a Sweet Government Contract.  All told, after the hours of preparation and then the on-site reviews, I received way below minimum wage.  Those of you who’ve done this recognize it’s a Labor of Love.  Or at least a professional responsibility to provide your expertise to ensure the funding goes to the most deserving proposals.