A thirty-year trend of increasing clinical orientation at the National Institutes of Health

It is widely recognized that funding for biomedical research supports the development of major medical advances. However, little systematic effort has been made to determine whether a link exists between the types of funding opportunities that are available to scientists and progress towards new treatments in the clinic. To better understand this relationship, we analyzed the funding opportunities offered by the National Institutes of Health (NIH) over a span of thirty-two years, together with the resulting portfolio of applications and awards. We found NIH funding opportunity announcements became more numerous and increasingly clinically oriented over that span, following a trend that parallels the increasing clinical and translational orientation of both NIH grant applications and NIH-funded publications. Surprisingly, this increase appears to be independent of the representation of clinician-scientists in the NIH workforce.