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MISSIONS OF VA Veterans of Armed Forces Patient care Research and education Backup medical care to DOD Cemetery management

>100 VA Hospitals Strong emphasis on clinician investigators

VA NOBEL LAUREATES Rosalyn Yalow Bronx VA - RIA Andrew Schally New Orleans VA Hypothalamic releasing factors Ferid Murad Palo Alto VA - NO

COOPERATIVE STUDIES PROGRAM CSP #4 – Coronary artery surgery I ( ) CSP #28 – Coronary artery surgery II ( ) CSP #90 - Prognosis and Outcome Following Heart Valve Replacement ( ) CSP #207 - Anti-platelet Therapy After CABG ( ) CSP #385 - Urgent Revascularization in Unstable Angina (AWESOME, ) CSP #411 - The coronary artery revascularization prophylaxis (CARP) trial (ongoing) CSP #474 – Radial artery vs saphenous vein grafts in CABG (ongoing) CSP #517 – Outcomes following myocardial revascularization: On & off cardiopulmonary bypass (ongoing) Cardiac Surgery

MERIT REVIEW SUB-COMMITTEES Aging & clinical geriatrics Infectious Diseases (A,B) Cardiovascular studies (A,B) Mental Health & Bipolar PTSD Clinical Research Program Mental Health Schizophrenia & Cog Endocrinology (A,B) Nephrology Gastroenterology Neurobiology (A-E) General Medical Science Oncology (A,B) Hematology Respiration Immunology (A,B) Surgery (A,B) 26

Major Changes Over Past 5 Years in Merit Review Process

OLD –2-3 internal –1-2 external NEW –2-3 internal –External only when necessary Reviews External reviewers were experts working directly in grant area Increasingly difficult to obtain, expensive

Page Limit OLD –15 pages of text –Figures and tables extra NEW –25 page limit –“NIH-type” format Difficult to document 15 pages of text Increasing amount of figures, tables As payline decreased, preliminary data increased

Page Limitations, Order and Content Requirements

Funding Medical research < 3% VA budget Almost 70% Investigator initiated OLD –$150,000 –5 year NEW –$125,000 –4 year max Payline?

Questions?