Quality and costs of commissioned vs. researcher-led NIHR research: retrospective cohort study of randomised controlled trials

The NIHR provides two main funding pathways: 'commissioned' (CP) and 'researcher-led' (RLP) projects. CPs are used to ensure NHS priorities are addressed. However, there is uncertainty regarding which provides the highest quality, best value for money, research. We compared the quality and cost of commissioned and research-led projects. We searched the NIHR Funded Portfolio database for randomised controlled trials (RCTs) funded by programmes offering both CP and RLP funding. The main outcome was journal impact factor for the main results paper. Other outcomes included: Altmetric score, relative citation ratio, total and per participant funding. T-tests were used to compare mean values. 82 eligible RCTs were identified, 30 commissioned and 52 researcher-led. One RLP did not progress beyond pilot; two (one CP and one RLP) did not publish a monograph; and 78 published main study results in a peer-reviewed journal. Among these, RLP projects had higher means scores than CP projects for: journal impact factor (111.2 and 40.8, respectively, p < 0.001); Altmetric score (223.8 and 116.8, p = 0.05); and relative citation ratio (8.0 and 4.4, p = 0.06). Among the full 82 RCTs, RLP mean total study and per participant funding were lower than CP: £1,429,913 vs. £1,353,034, p = 0.59; and £11,271 vs. £4425, p = 0.08. Researcher-led projects are more likely to result in higher impact research compared with commissioned studies. Further research is needed to understand the reasons, which could include: commissioned research addressing harder-to-do questions; commissioning brief quality; and/or research team motivation.