Inappropriate and appropriate selection of 'peers' in grant review.

OBJECTIVE To assess the members of the California Tobacco Related Diseases Research Program Behavioral and Public Health Research on Tobacco Study Section and those of the Agency for Health Care Policy and Research (AHCPR) Dissemination Study Section as "peers" to review tobacco policy research. Both study sections reviewed a similar grant application on tobacco policy research written by one of us (S.A.G.). DESIGN Search of MEDLINE for 1989 through 1993 with the keyword tobacco for Tobacco Related Diseases Research Program and AHCPR reviewers. As a control, the National Institutes of Health Cardiovascular Study Section, which reviewed a ventricular function grant submitted by the same author with the keyword heart, was analyzed. SETTING Not applicable. PATIENTS OR OTHER PARTICIPANTS Study section members. INTERVENTIONS None. MAIN OUTCOME MEASURES Publications by study section members in areas germane to the proposal being reviewed. RESULTS Six (33%) of 18 Tobacco Related Diseases Research Program reviewers had no "tobacco" publications (median, two publications; interquartile range, zero to four). The members' "tobacco" publications concentrated on well-controlled experimental interventions on smoking cessation and prevention strategies, not tobacco policy. Only one member had primary expertise in tobacco policy research. None of the AHCPR reviewers had "tobacco" publications. All 31 (100%) of the National Institutes of Health reviewers had "heart" publications (median, nine publications; interquartile range, seven to 19). Five members had a primary interest in the subject of the National Heart, Lung, and Blood Institute application. CONCLUSIONS Study section members' professional interests play a critical role in the level of interest and enthusiasm they will have for a proposal, which affects the priority score. In contrast to the study section that reviewed the heart grant, the study sections that reviewed the tobacco control grant were not "peers." The membership of these review committees has effectively precluded research on tobacco control policy.