A statistical model is proposed for the analysis of peer-review ratings of R01 grant applications submitted to the National Institutes of Health. Innovations of this model include parameters that reflect differences in reviewer scoring patterns, a mechanism to account for the transfer of information from an application's preliminary ratings and group discussion to final ratings provided by all panel members and posterior estimates of the uncertainty associated with proposal ratings. Application of this model to recent R01 rating data suggests that statistical adjustments to panel rating data would lead to a 25% change in the pool of funded proposals. Viewed more broadly, the methodology proposed in this article provides a general framework for the analysis of data collected interactively from expert panels through the use of the Delphi method and related procedures.hierarchical model ͉ item response model ͉ latent variable model ͉ ordinal data E very year, the National Institutes of Health (NIH) spend more than $22 billion to fund scientific research (1). Approximately 70% of these funds are awarded through a peerreview process overseen by the NIH Center for Scientific Review (CSR). Despite the vast sum of money involved, the absence of statistical methodology appropriate for the analyses of peerreview scores generated by this system has precluded the type of detailed assessment applied to other national health and educational systems (2, 3). As a consequence, statistical adjustments to account for uncertainties and biases inherent to these scores are not made before funding decisions. To address this deficiency, this article examines the properties of these ratings and proposes methodology to more efficiently extract the information contained in them.It is useful to begin with a brief review of the NIH peer-review system. Upon submission to the NIH, most grant applications (e.g., R01, R03, R21, etc.) are assigned to a study section within an Integrated Review Group (IRG) for review, and to an NIH Institute and Center (IC) for eventual funding. IRG study sections typically contain Ϸ30 members and review Ϸ50 grant applications (proposals) during each of three annual meetings. Because it is impractical for every member of a study section to review every application, between two and five reviewers are typically assigned to read and score each application before the study section convenes. In the sequel, these individuals are called the proposal's ''readers,'' and the scores they assign before a study section convenes are called ''pre-scores.'' Proposals are scored on a 1.0-5.0 scale in increments of 0.1 units, with 1.0 representing the best score. When the study section convenes, the scientific review officer (SRO) and the study section chair suggest a list of proposals that might be ''streamlined.'' Based on their pre-scores, proposals on this list are viewed as unlikely to receive fundable priority scores and, if no one in the study section objects, are not considered further. The remaining proposals are discusse...