The diagnostic phase of the peer-review self-study led the NIH and its stakeholders to articulate seven major challenges and associated goals and recommended actions to address each of them. The analysis clearly revealed the “systems” nature of peer review, pointing to the need for an integrated approach to enhancement. While each recommended action must be evaluated according to its own merit, the most optimal enhancement to the system will be achieved through the synergistic effects of multiple proposed actions.

Above all, it is critical that the NIH maintain the core values of peer review: scientific competence, fairness, timeliness, and integrity. When striving to fund the “best” science, the NIH must consider many factors, including scientific quality, public health impact, the mission of an NIH Institute or Center, and the current NIH portfolio.

The 2007-2008 NIH peer-review self-study identified seven major challenges:

• Challenge 1: Reducing Administrative Burden on Applicants, Reviewers, and NIH Staff
• Challenge 2: Enhancing the Rating System
• Challenge 3: Enhancing Review and Reviewer Quality
• Challenge 4: Optimizing Support for Different Career Stages and Types
• Challenge 5: Optimizing Support for Different Types and Approaches of Science
• Challenge 6: Reducing the Stress on the Support System of Science
• Challenge 7: Meeting the Need for Continuous Review of Peer Review