Abstract：
OBJECTIVE: The number of cerebrovascular (CV) surgeons has grown with the rise of endovascular neurosurgery. However, it is unclear whether the number of CV surgeon-scientists has concomitantly increased. With increasing numbers of CV neurosurgeons in the US workforce, the authors analyzed associated changes in National Institutes of Health (NIH) and Neurosurgery Research and Education Foundation (NREF) funding trends for CV surgeons over time.
METHODS: Publicly available data were collected on currently practicing academic CV surgeons in the US. Inflation-adjusted NIH funding between 2009 and 2021 was surveyed using NIH RePORTER and Blue Ridge Institute for Medical Research data. The K12 Neurosurgeon Research Career Development Program and NREF grant data were queried for CV-focused grants. Pearson R correlation, chi-square analysis, and the Mann-Whitney U-test were used for statistical analysis.
RESULTS: From 2009 to 2021, NIH funding increased: in total (p = 0.0318), to neurosurgeons (p < 0.0001), to CV research projects (p < 0.0001), and to CV surgeons (p = 0.0018). During this time period, there has been an increase in the total number of CV surgeons (p < 0.0001), the number of NIH-funded CV surgeons (p = 0.0034), and the percentage of CV surgeons with NIH funding (p = 0.370). Additionally, active NIH grant dollars per CV surgeon (p = 0.0398) and the number of NIH grants per CV surgeon (p = 0.4257) have increased. Nevertheless, CV surgeons have been awarded a decreasing proportion of the overall pool of neurosurgeon-awarded NIH grants during this time period (p = 0.3095). In addition, there has been a significant decrease in the number of K08, K12, and K23 career development awards granted to CV surgeons during this time period (p = 0.0024). There was also a significant decline in the proportion of K12 (p = 0.0044) and downtrend in early-career NREF (p = 0.8978) grant applications and grants awarded during this time period. Finally, NIH-funded CV surgeons were more likely to have completed residency less recently (p = 0.001) and less likely to have completed an endovascular fellowship (p = 0.044) as compared with non-NIH-funded CV surgeons.
CONCLUSIONS: The number of CV surgeons is increasing over time. While there has been a concomitant increase in the number of NIH-funded CV surgeons and the number of NIH grants awarded per CV surgeon in the past 12 years, there has also been a significant decrease in CV surgeons with K08, K12, and K23 career development awards and a downtrend in CV-focused K12 and early-career NREF applications and awarded grants. The latter findings suggest that the pipeline for future NIH-funded CV surgeons may be in decline.
METHODS: Publicly available data were collected on currently practicing academic CV surgeons in the US. Inflation-adjusted NIH funding between 2009 and 2021 was surveyed using NIH RePORTER and Blue Ridge Institute for Medical Research data. The K12 Neurosurgeon Research Career Development Program and NREF grant data were queried for CV-focused grants. Pearson R correlation, chi-square analysis, and the Mann-Whitney U-test were used for statistical analysis.
RESULTS: From 2009 to 2021, NIH funding increased: in total (p = 0.0318), to neurosurgeons (p < 0.0001), to CV research projects (p < 0.0001), and to CV surgeons (p = 0.0018). During this time period, there has been an increase in the total number of CV surgeons (p < 0.0001), the number of NIH-funded CV surgeons (p = 0.0034), and the percentage of CV surgeons with NIH funding (p = 0.370). Additionally, active NIH grant dollars per CV surgeon (p = 0.0398) and the number of NIH grants per CV surgeon (p = 0.4257) have increased. Nevertheless, CV surgeons have been awarded a decreasing proportion of the overall pool of neurosurgeon-awarded NIH grants during this time period (p = 0.3095). In addition, there has been a significant decrease in the number of K08, K12, and K23 career development awards granted to CV surgeons during this time period (p = 0.0024). There was also a significant decline in the proportion of K12 (p = 0.0044) and downtrend in early-career NREF (p = 0.8978) grant applications and grants awarded during this time period. Finally, NIH-funded CV surgeons were more likely to have completed residency less recently (p = 0.001) and less likely to have completed an endovascular fellowship (p = 0.044) as compared with non-NIH-funded CV surgeons.
CONCLUSIONS: The number of CV surgeons is increasing over time. While there has been a concomitant increase in the number of NIH-funded CV surgeons and the number of NIH grants awarded per CV surgeon in the past 12 years, there has also been a significant decrease in CV surgeons with K08, K12, and K23 career development awards and a downtrend in CV-focused K12 and early-career NREF applications and awarded grants. The latter findings suggest that the pipeline for future NIH-funded CV surgeons may be in decline.
摘要：
目的：脑血管（CV）外科医师的数量随着血管内神经外科手术的兴起而增长。然而,尚不清楚CV外科医生的数量是否随之增加。随着美国劳动力中CV神经外科医生数量的增加，作者分析了随着时间的推移,美国国立卫生研究院(NIH)和神经外科研究与教育基金会(NREF)对CV外科医生的资助趋势的相关变化.
方法：收集了目前在美国执业的学术CV外科医生的公开数据。使用NIHRePORTER和BlueRidge医学研究所的数据调查了2009年至2021年之间经通货膨胀调整的NIH资金。查询了K12神经外科医生研究职业发展计划和NREF资助数据，以获取以CV为重点的资助。皮尔逊R相关，卡方分析，采用Mann-WhitneyU检验进行统计分析。
结果：从2009年到2021年，NIH资金增加：总计（p=0.0318），对神经外科医生(p<0.0001)，CV研究项目（p<0.0001），和CV外科医生（p=0.0018）。在此期间,CV外科医生的总数有所增加（p<0.0001），NIH资助的CV外科医生人数（p=0.0034），以及获得NIH资助的CV外科医生的百分比（p=0.370）。此外,每位CV外科医生的活跃NIH补助金（p=0.0398）和每位CV外科医生的NIH补助金数量（p=0.4257）有所增加。然而，在这段时间内，CV外科医生在神经外科医生授予的NIH补助金总数中所占的比例正在下降（p=0.3095）。此外,在此期间,授予CV外科医生的K08,K12和K23职业发展奖的数量显著减少(p=0.0024).在此期间，K12的比例（p=0.0044）和职业生涯早期NREF（p=0.8978）赠款申请和赠款的下降趋势也显着下降。最后,与非NIH资助的CV外科医生相比，NIH资助的CV外科医生更有可能最近完成住院医师（p=0.001），并且不太可能完成血管内研究金（p=0.044）。
结论：CV外科医生的数量随着时间的推移而增加。虽然在过去的12年中，NIH资助的CV外科医生的数量以及每位CV外科医生获得的NIH资助的数量也随之增加，获得K08,K12和K23职业发展奖的CV外科医生也显著减少,以CV为重点的K12和早期职业NREF申请和授予的资助也呈下降趋势.后者的发现表明，未来NIH资助的CV外科医生的管道可能正在下降。
方法：收集了目前在美国执业的学术CV外科医生的公开数据。使用NIHRePORTER和BlueRidge医学研究所的数据调查了2009年至2021年之间经通货膨胀调整的NIH资金。查询了K12神经外科医生研究职业发展计划和NREF资助数据，以获取以CV为重点的资助。皮尔逊R相关，卡方分析，采用Mann-WhitneyU检验进行统计分析。
结果：从2009年到2021年，NIH资金增加：总计（p=0.0318），对神经外科医生(p<0.0001)，CV研究项目（p<0.0001），和CV外科医生（p=0.0018）。在此期间,CV外科医生的总数有所增加（p<0.0001），NIH资助的CV外科医生人数（p=0.0034），以及获得NIH资助的CV外科医生的百分比（p=0.370）。此外,每位CV外科医生的活跃NIH补助金（p=0.0398）和每位CV外科医生的NIH补助金数量（p=0.4257）有所增加。然而，在这段时间内，CV外科医生在神经外科医生授予的NIH补助金总数中所占的比例正在下降（p=0.3095）。此外,在此期间,授予CV外科医生的K08,K12和K23职业发展奖的数量显著减少(p=0.0024).在此期间，K12的比例（p=0.0044）和职业生涯早期NREF（p=0.8978）赠款申请和赠款的下降趋势也显着下降。最后,与非NIH资助的CV外科医生相比，NIH资助的CV外科医生更有可能最近完成住院医师（p=0.001），并且不太可能完成血管内研究金（p=0.044）。
结论：CV外科医生的数量随着时间的推移而增加。虽然在过去的12年中，NIH资助的CV外科医生的数量以及每位CV外科医生获得的NIH资助的数量也随之增加，获得K08,K12和K23职业发展奖的CV外科医生也显著减少,以CV为重点的K12和早期职业NREF申请和授予的资助也呈下降趋势.后者的发现表明，未来NIH资助的CV外科医生的管道可能正在下降。
