Meta-research: justifying career disruption in funding applications, a survey of Australian researchers.

Background: When researchers' careers are disrupted by life events - such as illness or childbirth - they often need to take extended time off. This creates a gap in their research output that can reduce their chances of winning funding. In Australia, applicants can disclose their career disruptions and peer reviewers are instructed to make appropriate adjustments. However, it is not clear if and how applicants use career disruption sections or how reviewers adjust and if they do it consistently. Methods: To examine career disruption, we used surveys of the Australian health and medical research community. We used both a random sample of Australian authors on PubMed and a non-random convenience sample. Results: Respondents expressed concerns that sharing information on career disruption would harm their chances of being funded, with 13% saying they have medical or social circumstances but would not include it in their application, with concerns about appearing 'weak'. Women were more reluctant to include disruption. There was inconsistency in how disruption was adjusted for, with less time given for those with depression compared with caring responsibilities, and less time given for those who did not provide medical details of their disruption. Conclusions: The current system is likely not adequately adjusting for career disruption and this may help explain the ongoing funding gap for senior women in Australia. Funding: National Health and Medical Research Council Senior Research Fellowship (Barnett).

Science is an expensive endeavor. To pursue their ideas, most researchers need to win funding by submitting applications to highly competitive schemes with low success rates. Funding decisions depend on many factors, but usually take into consideration a researcher's track record: publications, collaborations with other researchers and even other awards they have received. Researchers whose careers have been disrupted by life events, including childbearing or being ill, may have a gap in their track record that reduces their chances of winning funding. Historically, female researchers have experienced career disruptions more often, leading to a funding gap between male and female researchers. To increase fairness and reduce this gap, many funding agencies have instructed the peer reviewers ­ other scientists ­ who assess funding applications to adjust their scores to account for career disruptions. However, large funding gaps are still frequently observed between female and male researchers. Barnett et al. wanted to know how career disruption is considered in practice by establishing what personal details are shared in applications by researchers with disruption, and how reviewers treat this information. To find out, they surveyed medical researchers in Australia and asked them for their views on career disruption as both funding applicants and reviewers of funding applications. The answers to the survey indicated that 13% of the applicants responding had experienced career disruptions, but would not include them in funding applications. In many cases, this reluctance to disclose career disruptions was due to concerns that it would harm an applicant's chances of winning funding, a concern that was greater in the women who responded to the survey. Researchers who answered the survey would claim less time off on average if their career disruption was for severe depression compared with caring for a child or elderly relative. Additionally, the answers to the survey show that, on average, peer reviewers ­ the scientists who assessed the applications ­ would give more time off to applicants who provided details about the medical issues that caused a career disruption than to those who did not. The results of this survey suggest that changes in the systems used to apply for funding and in how applications are assessed could make funding fairer. One suggestion would be to modify funding applications to make disruptions easier to report. Another would be to make changes to the reviewing procedures to increase privacy and reduce variability in how disruption is assessed. Changes in these directions could help researchers gain access to funding more fairly, increasing the quality and output of scientific research.

Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care.

Background: Evaluating integrated care programs is complex. Integration benefits may not become apparent within short evaluation timeframes, and many programs provide a wide variety of health and non-health benefits. To address these challenges, we illustrate a mixed methods approach for evaluating multiple integrated care programs using multi-criteria decision analysis. Methods: We adapted a decision support tool used by local decision makers to compare data extracted from 17 different integrated care evaluations. Criteria included impact on health services capacity, patient outcomes, integration of care, workforce development and implementation risk, weighted based on stakeholder preferences. Program benefits were compared to their implementation costs, and assessed using cost-effectiveness methods. Sensitivity analysis examined the impact of different criteria weights. Results and discussion: This method captured a diverse range of benefits provided by integrated care programs and provided an accessible heuristic to compare many projects simultaneously. However, this approach may not be sensitive to the appropriateness of each criterion to the health system, the magnitude of difference in individual criteria, equity considerations or socio-political factors. Internal and external validation, especially for subjective criteria such as implementation risk, are needed. Conclusions: This work offers a feasible, flexible and pragmatic approach for evaluating integrated care programs.

Correction: Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care.

[This corrects the article DOI: 10.5334/ijic.5997.].