Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Because only a small portion of the total variance in deficiencies could be explained, much work remains to explore factors that influence deficiencies.

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The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.

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Purpose Career advancement in academic medicine often hinges on the ability to garner research funds, and the National Institutes of Health’s (NIH’s) R01 award is the “gold standard” of an independent research program. Studies show inconsistencies in R01 reviewers’ scoring and in award outcomes for certain applicant groups. Consistent with the NIH recommendation to examine potential bias in R01 peer review, the authors performed a text analysis of R01 reviewers’ critiques. Method The authors collected 454 critiques (262 from 91 unfunded and 192 from 67 funded applications) from 67 of 76 (88%) R01 investigators at the University of Wisconsin-Madison with initially unfunded applications subsequently funded between December 2007 and May 2009. To analyze critiques the authors developed positive and negative grant application evaluation word categories and selected 5 existing categories relevant to grant review. The authors analyzed results with linear mixed effects models for differences due to applicant and application characteristics. Results Critiques of funded applications contained more positive descriptors and superlatives and fewer negative evaluation words than critiques of unfunded applications. Experienced investigators’ critiques contained more references to competence. Critiques showed differences due to applicant sex despite similar application scores or funding outcomes: more praise for applications from female investigators; greater reference to competence/ability for funded applications from female experienced investigators; and more negative evaluation words for applications from male investigators (Ps < .05). Conclusions Results suggest that text analysis is a promising tool for assessing consistency in R01 reviewers’ judgments and gender stereotypes may operate in R01 review.