Comparing Cutaneous Research Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with 2010 Global Burden of Disease Results

Abstract

ImportanceDisease burden data helps guide research prioritization.ObjectiveTo determine the extent to which grants issued by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) reflect disease burden, measured by disability-adjusted life years (DALYs) from Global Burden of Disease (GBD) 2010 project.DesignTwo investigators independently assessed 15 skin conditions studied by GBD 2010 in the NIAMS database for grants issued in 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010.SettingThe United States NIAMS database and GBD 2010 skin condition disability data.Main Outcome(s) and Measure(s)Relationship of NIAMS grant database topic funding with percent total GBD 2010 DALY and DALY rank for 15 skin conditions.ResultsDuring fiscal year 2013, 1,443 NIAMS grants were issued at a total value of $424 million. Of these grants, 17.7% covered skin topics. Of the total skin disease funding, 82% (91 grants) were categorized as “general cutaneous research.” Psoriasis, leprosy, and “other skin and subcutaneous diseases” (ie; immunobullous disorders, vitiligo, and hidradenitis suppurativa) were over-represented when funding was compared with disability. Conversely, cellulitis, decubitus ulcer, urticaria, acne vulgaris, viral skin diseases, fungal skin diseases, scabies, and melanoma were under-represented. Conditions for which disability and funding appeared well-matched were dermatitis, squamous and basal cell carcinoma, pruritus, bacterial skin diseases, and alopecia areata.Conclusions and RelevanceDegree of representation in NIAMS is partly correlated with DALY metrics. Grant funding was well-matched with disability metrics for five of the 15 studied skin diseases, while two skin diseases were over-represented and seven were under-represented. Global burden estimates provide increasingly transparent and important information for investigating and prioritizing national research funding allocations.

A Review of Scabies: An Infestation More than Skin Deep

“…Funding will be required to support an increase in scabies research; priority areas include the development of robust diagnostic tests for scabies, and improved treatment and control strategies, particularly in view of the emerging threat of drug resistance. In the USA, funding for scabies research was shown to be under-represented in relation to the associated disease burden, and this gap needs to be addressed [89]. In the UK research and policy efforts should address the management of scabies outbreaks in institutions, with particular focus on the use of oral treatments, such as ivermectin or moxidectin, and increasing the availability of these drugs.…”

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

“…[1][2][3][4] GBD facilitates epidemiologic comparison of disease burden. 5,6 Fifteen skin conditions are represented in the study along with a category for ''other skin and subcutaneous diseases.'' Before GBD 2010, in 1998, the Institute of Medicine (IOM) urged the National Institutes of Health (NIH) to correlate burden of disease with US funding distribution.…”

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…11 A further analysis of how skin disease burden in the 2010 surveys was matched by research funding from the US National Institutes of Health indicated that some diseases such as dermatitis and NMSC were well matched, whereas others such as cellulitis, pressure ulcers, urticaria, acne, viral and fungal diseases, scabies, and melanoma were less well represented. 772 A similar pattern of under-representation was evident for systematic reviews published by The Cochrane Collaboration. Measurement of skin disease burden using disability-adjusted life-year metrics allows comparison with other diseases.…”