This is a brief summary of the September 9, 2008, meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC). It will be replaced by the full minutes of the meeting when they become available.

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OPENING REMARKS AND REPORT OF THE DIRECTOR

Dr. Elizabeth Nabel, Director of the National Heart, Lung, and Blood Institute (NHLBI), welcomed members to the 231st meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC). Because the September Council meeting is brief, most members participated via video-conference or telephone.

Dr. Nabel announced that Dr. Keith Hoots will join the Institute in January as Senior Advisor to the Director in the Division of Blood Diseases and Resources. Dr. Hoots is expected to assume leadership of the Division as time goes on. Dr. Hoots is currently Professor of Pediatrics and Division Head, Pediatric Hematology, The University of Texas Medical School at Houston; Section Head, Pediatric Hematology, The University of Texas M.D. Anderson Cancer Center; and Medical Director, Gulf State Hemophilia and Thrombophilia Treatment Center. Dr. Hoots is a past president of the Hemophilia Research Society of North America.

The Institute recently reviewed its global health program in light of the major impact of chronic disease worldwide. In response to the recommendations of an Advisory Group convened by Dr. Nabel, the Institute has embarked on several activities:

• Requesting that the Institute of Medicine update its report on the epidemiology of cardiovascular disease worldwide.
• Partnering with the Fogarty International Center at the NIH, together with other Institutes/Centers, to support bilateral training programs.
• Looking into a role for the Institute in programs that target chronic cardiovascular and pulmonary diseases in developing countries, focusing on training, surveillance, risk assessment, and primary prevention.

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Budget Report

Dr. Nabel reported that the Institute's payline for traditional research project grants (R01s) is at the 16th percentile as we approach the end of FY 2008; at the 26th percentile for new investigators' R01s (if expedited administrative review resolves summary statement comments); and at the 21st percentile for first-time renewal R01 applications from new investigators. This year, the Institute was able to fund program project grants with a composite priority score of 150 or better (subprojects with a score of 170 or better); career development grants with a score of 165 or better; and training grants with a score of 172 or better. Furthermore, in keeping with its efforts to support new investigators, the Institute was able to fund fellowship grants to the 40th percentile. Dr. Nabel noted that the Institute's funding scores have remained fairly stable over the last 3 to 4 years.

In FY 2008, the NIH received a $150 million supplement from Congress, of which the NHLBI share was $15.5 million. The NHLBI used 56 percent of its share to fund competing research project grants (RPGs) and was able to fund, in percentile order, 13 original (unamended) grant applications with percentile scores outside the regular payline.

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Policy Issues related to Amended Applications and Early-stage Investigators

Dr. Nabel reported on two policy issues recently reviewed at the NIH. She welcomed feedback from Council.

• Amended Applications: After review of recommendations from the recent NIH-led study of its peer review system, the NIH has decided to consider phasing out second amendments (A2s) to competing RPG applications.
• Early-stage Investigators: The NIH is discussing how to focus support more effectively toward early-stage investigators, having found that a substantial portion of the new investigators it has recently supported (i.e., those who met the NIH criteria for "new investigators") were not early-stage investigators, but rather experienced researchers established in other fields of science. Under consideration is establishing policy to maintain equal success rates for both groups—early-stage and established investigators.

Council members offered opinions and suggestions regarding both issues.