Grant Writing Strategies: A Tale of Two Equations

1. Grant Writing Strategies:A Tale of Two Equations Richard W Grant MD MPH Clinical and Translational Science Institute Career Development Program September 28, 2012

2. Step 2: Understand how Qa becomes Sf (Final Score) Sf = [Qa x Rp]  error term Step 1: Maximize Qa (Actual Quality) Qa = [ (QI + TE) x CW ]

3. Quality of Idea Team & Environ Clarity of Writing Step 1: Maximize Qa (Actual Quality) Qa = [ (QI + TE) x CW ] Well-written CW > 1 Less well-written CW < 1 Key Parameters for Qa: 1. Quality of Idea 2. Team & Environment 3. Clarity of Writing

4. “diamond in the rough” “sow’s ear/silk purse” The Importance of Starting Off With A Very Good Idea Initial Idea + Hours and Hours work = Final score Final Score Funding Line Initial Idea Very Good Idea Good Idea

5. How do you get a “Very Good Idea”? • I have no advice • This is the essence of science • But… • Know the edge of the current evidence • Choose important questions • Why should we fund this? • Who cares?

6. Anyway, you don’t “get” Very Good Ideas • Good grants evolve • Rely on group learning • Should elicit enthusiasm • Talk to in-field researchers • Talk to out-of-field researchers • Make strategic decisions • Keep track & add these to the end of your grant

7. Team & Environment • Identify and use your institution’s strengths • Look for missing pieces, e.g. • Qualitative expert if you are not • Biostatistician • Begin well ahead of time establishing track record of collaboration • Write papers together

8. Clarity of Writing • Concise • Less words = more space • Space and figures • More space = less eye strain • Reading group • Clarity of writing = no misunderstanding

9. Scalpel • This method is neither specific nor sensitive enough for identifying which patients are most in need of intervention. • 19 words, 100 characters • This method is neither specific nor sensitive enough to identify patients most in need of intervention. • 17 words, 88 characters

10. Axe 1A. Diabetes has been increasing in incidence by 5% per year in both developing and economically more advanced countries. In Africa, for example, chronic disease such as diabetes now account for one-third of health care budgets, the second leading cost after infectious diseases. In the US, diabetes care consumes 130 billion health care dollars a year and is responsible for one-fourth of all hospitalizations. 1B. Despite availability of evidence-based guidelines derived from large randomized clinical trials, many patients with type 2 diabetes do not meet goals of care. For example, one-third of patients have elevated LDL levels, including 30% of patients treated with statins, and over half of patients do not meet glycemic or blood pressure goals. 1A. Diabetes is an epidemic involving more than 300 million people worldwide. Current health systems fall short of delivering evidence-based care, with < 5% of patient in US achieving all care goals.

11. Shape In order to demonstrate and evaluate the value of an intervention to implement a new and innovative approach to addressing the pressing problem of increased weight gain and unhealthy behaviors among low income Latina and African-American women, the proposal will implement a 3-step intervention that includes weight assessment, individual patient interviews, and a personalized web-based coaching protocol. One long sentence → two clear sentences with distinct ideas Increased weight gain and unhealthy behaviors are a pressing problem among low income Latina and African-American women. To address this problem, we will implement a 3-step intervention: • Weight assessment • Individual patient interviews • Web-based coaching

13. Reading group • Invest the effort in other people’s writing • Read it like you mean it • Karma • Make reservations with your outside readers • Send early or late draft?

14. How Writers Spend Their Time Where we often lose points on score Hours Spent Writing & Editing Specific Aims Background & Significance Innovation & Impact Aim 1 Aim 3 Aim 2 Summary

15. Assemble Team Strategic Decisions, Draft Aims Leave 3 months For writing Creative Ideas, Available Resources Talk to PO Grant Timeline • One Year Plan “Writing Phase” - talk about ideas - writing group - budget, letters, etc - don’t rush at end “Pre-Writing Phase” - make connections - write papers/abstracts together - learn the literature - what needs to be learned?

16. Research Timeline “Paper #1” “Paper #2” “Writing Phase” “Writing Phase” “Writing Phase” “Pre-Writing Phase” “Pre-Writing Phase” “Pre-Writing Phase”

17. The Life of a Researcher Collaborate, talk to people, mentor, connect, review, think, WRITE, meet, manage “Co-author #1” “Co-Investigator Grant”

18. Review order, Reviewer Fatigue, etc Reviewer Perception Step 1: Maximize Qa (Actual Quality) Quality of Idea Team & Environ Clarity of Writing Qa = [ (QI + TE) x CW ] Step 2: The Review Process = Final Score (Sf) [ x Rp] Sf =Qa  error term (unexplained variance)

19. Reviewer Perception • Need to have empathy for the process • Need to understand study section

20. The Review Process • Each reviewer has 8-12 grants to review • Short bulleted assessments and numeric scores • Primary reviewer needs to briefly summarize and then explain strengths and weakness • i.e. your 6 months of work in 5 minutes

21. The Review Process • “Shouting down a tunnel” “I’d like to conduct a 3-arm study stratified by baseline CRKT score with two-levels of intervention that includes an “analysis cohort” as well as the usual care “all comers” low CRKT cohort that will be analyzed separately for hypothesis generation and validation of our CRKT-CDC intervention models” “Something about crickets…”

22. Reviewers • “Uniformed skeptics with axes to grind” • Need to hear voices in your head • Background: • Give them a vague sense of panic about the problem you will address

23. The Review Process • Your proposal can unravel during study section if there is a loose thread that gets pulled on

24. Aims Statistical Methods Design Technical Methods Outcomes Bad: “I didn’t get how they were going to do what they said they were doing” “They need to include a (biostatistician, other expert) on the team” Good: Reviewer able to clearly summarize project in 30 seconds “They really know what they’re doing” Balancing Act Sophistication Simplicity

25. Quality of Idea Team & Environ Clarity of Writing Multiple Outside Readers Talk with Others Identify Strengths Pull in Missing Expertise Review order, Reviewer Fatigue, etc Anticipate and Pre-Address the usual criticisms ???? Step 1: Maximize Qa (Actual Quality) Qa = [ (QI + TE) x CW ] Step 2: The Review Process = Final Score Reviewer Perception Sf = [Qa x Rp]  error term (unexplained variance) Anticipate and Pre-Address the usual criticisms

26. CTSI Program Resources • RO1 resources: • 6 week course with Tom and Alka • The Grant Application Writer’s Workbook by Stephen W Russell and David C Morrison • Tom’s one-on-one grant writing (with considerable lead time) • Tom and Alka “developing specific aims” small group in the winter/spring • Grant reviews (more details to follow)