Let’s talk about research – by Anna Morris
Our regular blogger Helen May recently wrote about Diabetes UK’s research strategy. Here Anna Morris, Head of Research Funding at Diabetes UK, responds to Helen’s questions.
As I read through Helen’s blog I found myself nodding in agreement. As Helen has highlighted there are a number of important decisions that Diabetes UK must make as it funds research and those decisions are not to be taken lightly.
If we get it right, the projects that we fund today and the scientists that make the research happen could, in the future, go on to change the face of care and treatment for people with diabetes – and ultimately deliver us a cure.
How do we decide what to fund?
It’s a good question and the answer is that we don’t – well, not directly – and I’ll come on to that. Helen asked us what we focus on: where do we put our money? Type 2 diabetes, MODY, people at risk, people that have lived with diabetes for years, innovative research or young scientists? These are all incredibly important causes, and we don’t focus on any of them more than another. As you’ll see below, they’re all touched upon through our decision making process.
So back to who makes the decisions. It’s really important that Charity staff are not directly involved in deciding what gets funded. The process that we go through to allocate the research budget, which sits between £6.5 and £7 million each year, needs to be independent and rigorous, and that means that we use the expertise of scientists from across the globe and the views of people living with diabetes to help us make the right choices.
Ultimately it’s just how Helen carved up her budget when she was a Product Manager. Potential research projects, of which we receive around 200 per year, are assessed against set criteria, such as potential impact, novelty and value for money, and those that score best against those criteria are funded.
Thousands of scientists are involved
Firstly all grant applications undergo a process called peer review, and that means that we ask a number of scientists who work in the area of research covered in the application to read it and tell us how well they think it meets the set criteria. For each application we will have feedback from at least three scientists (which means for each application round we need to approach around 1,000 scientists!) and we make sure that they are independent experts who haven’t worked with the applicants and who are not based at the same University or Hospital. This part of the process tells us whether the science is important and novel, whether it’s good value for money, whether the scientists are the right people to do it and whether the study is structured properly so that we will be able to trust the results.
People with diabetes have their say too
Next the applications are seen by our Grants Advisory Panel. This Panel consists of 17 people living with diabetes and they look at the applications and score them as low, medium or high priority. To reach this priority the Panel will be asking whether the potential impact of the research is relevant and important to people living with diabetes; if it’s a study that involves people, is what’s being asked of the participants reasonable, and would they take part themselves?
Round the table
Finally, armed with the peer review feedback and the views of the Grants Advisory Panel, our Research Committee, made up of senior scientists, healthcare professionals and people living with diabetes, meets to make the final recommendations. At the end of that meeting we leave the room with our list of funded projects.
To answer Helen’s question about how we balance the portfolio between Type 1 and Type 2 – the Research Committee doesn’t have a set amount of money for each type of diabetes. Instead it allocates the funding based on the criteria I mentioned earlier, such as whether the science is important and novel and whether it’s important to people with diabetes, and in fact many applications are relevant to both forms of diabetes. However, we at Diabetes UK do keep a watch on the balance of funding and would take action if we were concerned that the balance was tipping too far in either direction. In reality we usually find that there is a fairly equal balance of the two. At the moment, we’re funding around £25 million of active research, and that falls relatively equally between Type 1 and Type 2 (with some research focussing on rarer genetic forms of diabetes).
While the Research Team doesn’t directly make the funding decisions it doesn’t mean that we don’t have an important role to play in ensuring that research benefits people with diabetes as quickly as possible. Lots of the research we fund will come from a scientist having an idea, and then we take it through our decision making process. But we need to keep sight of the big research picture, to find any important gaps, highlight priorities and find ways to fund that research.
To help us do that, we are in the process of setting up Clinical Studies Groups (CSGs) for diabetes. Essentially, these groups will bring together scientists, healthcare professionals and people living with diabetes to identify the gaps and priorities for diabetes research and to put in place a roadmap for research. The CSGs will also consider the outputs of the James Lind Priority Setting Partnerships that Helen mentioned.
When can we expect a cure?
Now to Helen’s final question. We know that a cure could mean very different things to different people and that it might vary between people affected by the different forms of diabetes. While it’s impossible to say that a cure is just round the corner, we can be sure that we’re doing everything we can to find it. We’re currently funding a number of studies that could help us get there faster – find out more about our research projects.
I hope that this gives you a clearer picture of how Diabetes UK reaches a decision on which research to fund and I hope you’ll agree that it’s a robust process. Ultimately, we fund research which we and our advisory groups believe has the potential to make life better for people living with diabetes today, prevent it in those who may develop it in the future and one day lead us to a cure. As you’ve identified, there are tough decisions to be made on the way but we, and the scientists that we support, won’t stop working until we’ve done that.