What Is ROI in Medical Research?

Question: How much is the NIH's funding process affected by politics?

Francis Collins: We’re fortunate at NIH, that the Congress has in general has adopted a view that making priority decisions about scientific research is best done by scientists.  People talk about areas in other parts of the government where there’s earmarking or sometimes in a less friendly way called "pork" funding; we are relatively free of that.  Congress will certainly indicate to us when they think there is an area that needs more attention, but rarely will they attach a specific dollar figure to that.  They’ll just ask us to look at that a little more carefully.  So we have a very good working relationship.  

Likewise with the administration.  The administration is interested in seeing NIH be very productive and they want to hear all the time about how we’re spending our money and have us defend why it’s the right way to go.  But they’re generally reluctant to say, “Well you should spend X dollars on Y disease.”  And that just doesn’t seem like the way to make the choices.

Question:
How much say should the public have about what federal research money is spent on?


Francis Collins: Well the public does have a lot of say.  We have many disease advocacy groups who are constantly putting forward their case for why more research needs to be done on their condition, and of course, I would love to meet all of those requests, but we are often stuck in a situation where we’re limited in resources, and so we can’t do everything.  

But certainly we work I think pretty effectively with a lot of those groups to identify where are the areas that are most ripe for investment.  And sometimes that means coming up with an RFA because something is about to break.  Sometimes it’s organizing a workshop and trying to survey the field of a disease that seems to have gotten stuck for a while and figure out how to get it unstuck, and figure out how to get some new ideas and new scientific minds working on the problem.  I would say, for the most part, we have very productive, synergistic, friendly relationships with disease advocates who understand how the process works, are anxious to see resources put into their disease, but want it to be done in a fashion that’s scientifically productive and not just throwing money at the problem.

Question:
Are there areas of medicine or technologies where research dollars go farther?

Francis Collins: Return on investment is always an interesting question when it comes to medical research.  Well, what would you call "return?"  Is it that you’ve published a certain number of papers?  Well, that is one metric I suppose and that they are in high-impact journals, that’s another metric.  But really what we’re about is trying to help people.  

So the real return you’re looking for is clinical benefits, diagnostics, therapeutics, preventive measures.  The lead time on those is often measured in years.  And so it maybe quite difficult to assess when you’re just looking at a program that’s been underway for three or four years, how does it measure up in terms of what you’re getting for your dollars compared to some other program that similarly is sort of in an early stage of moving into clinical benefits?  But we try to do that to the extent we can and I think we should.  This is taxpayers' money; the taxpayers believe in us as the place that is gonna make that next breakthrough.  They want to be assured that we’re using those dollars in the most effective way possible.  Sometimes people think NIH is just, you know, playing around in the lab.  I can assure that’s not the view of people here, but we need to be prepared at any moment to defend the choices we’ve made as having had the best chance of benefiting real people out there who are counting on us to use their money wisely.  It is their money.

Recorded September 13, 2010
Interviewed by David Hirschman

The real "return" on research investments is in clinical benefits, diagnostics, therapeutics, and preventive measures. The lead time on those is often measured in years, so they can be hard to directly correlate to investments.

China's "artificial sun" sets new record for fusion power

China has reached a new record for nuclear fusion at 120 million degrees Celsius.

Credit: STR via Getty Images
Technology & Innovation

This article was originally published on our sister site, Freethink.

China wants to build a mini-star on Earth and house it in a reactor. Many teams across the globe have this same bold goal --- which would create unlimited clean energy via nuclear fusion.

But according to Chinese state media, New Atlas reports, the team at the Experimental Advanced Superconducting Tokamak (EAST) has set a new world record: temperatures of 120 million degrees Celsius for 101 seconds.

Yeah, that's hot. So what? Nuclear fusion reactions require an insane amount of heat and pressure --- a temperature environment similar to the sun, which is approximately 150 million degrees C.

If scientists can essentially build a sun on Earth, they can create endless energy by mimicking how the sun does it.

If scientists can essentially build a sun on Earth, they can create endless energy by mimicking how the sun does it. In nuclear fusion, the extreme heat and pressure create a plasma. Then, within that plasma, two or more hydrogen nuclei crash together, merge into a heavier atom, and release a ton of energy in the process.

Nuclear fusion milestones: The team at EAST built a giant metal torus (similar in shape to a giant donut) with a series of magnetic coils. The coils hold hot plasma where the reactions occur. They've reached many milestones along the way.

According to New Atlas, in 2016, the scientists at EAST could heat hydrogen plasma to roughly 50 million degrees C for 102 seconds. Two years later, they reached 100 million degrees for 10 seconds.

The temperatures are impressive, but the short reaction times, and lack of pressure are another obstacle. Fusion is simple for the sun, because stars are massive and gravity provides even pressure all over the surface. The pressure squeezes hydrogen gas in the sun's core so immensely that several nuclei combine to form one atom, releasing energy.

But on Earth, we have to supply all of the pressure to keep the reaction going, and it has to be perfectly even. It's hard to do this for any length of time, and it uses a ton of energy. So the reactions usually fizzle out in minutes or seconds.

Still, the latest record of 120 million degrees and 101 seconds is one more step toward sustaining longer and hotter reactions.

Why does this matter? No one denies that humankind needs a clean, unlimited source of energy.

We all recognize that oil and gas are limited resources. But even wind and solar power --- renewable energies --- are fundamentally limited. They are dependent upon a breezy day or a cloudless sky, which we can't always count on.

Nuclear fusion is clean, safe, and environmentally sustainable --- its fuel is a nearly limitless resource since it is simply hydrogen (which can be easily made from water).

With each new milestone, we are creeping closer and closer to a breakthrough for unlimited, clean energy.

The science of sex, love, attraction, and obsession

The symbol for love is the heart, but the brain may be more accurate.

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  • How love makes us feel can only be defined on an individual basis, but what it does to the body, specifically the brain, is now less abstract thanks to science.
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  • Dr. Fisher, professor Ted Fischer, and psychiatrist Gail Saltz explain the different types of love, explore the neuroscience of love and attraction, and share tips for sustaining relationships that are healthy and mutually beneficial.

Golden blood: The rarest blood in the world

We explore the history of blood types and how they are classified to find out what makes the Rh-null type important to science and dangerous for those who live with it.

Abid Katib/Getty Images
Surprising Science
  • Fewer than 50 people worldwide have 'golden blood' — or Rh-null.
  • Blood is considered Rh-null if it lacks all of the 61 possible antigens in the Rh system.
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There never was a male fertility crisis

A new study suggests that reports of the impending infertility of the human male are greatly exaggerated.

Sex & Relationships
  • A new review of a famous study on declining sperm counts finds several flaws.
  • The old report makes unfounded assumptions, has faulty data, and tends toward panic.
  • The new report does not rule out that sperm counts are going down, only that this could be quite normal.
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