115-553: The Patient-Reported Outcomes Measurement Information System ( PROMIS ) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient perspective. PROMIS measures are standardized, allowing for assessment of many patient-reported outcome domains—including pain, fatigue, emotional distress, physical functioning and social role participation—based on common metrics that allow for comparisons across domains, across chronic diseases, and with
230-410: A metonym for the federal government. The United States government is based on the principles of federalism and republicanism , in which power is shared between the federal government and state governments . The interpretation and execution of these principles, including what powers the federal government should have and how those powers can be exercised, have been debated ever since the adoption of
345-656: A Technology Center, both operated by Northwestern University. These centers provided logistical and technical support to PROMIS. In September 2014, the NIH extended its support to PROMIS through funding the National Person Centered Assessment Resource (PCAR/HealthMeasures). Three other measurement systems, Quality of Life in Neurologic Disorders (Neuro-QoL), Adult Sickle Cell Quality of Life Measurement system (ASCQ-Me), and
460-471: A certain percentage (2.8% in 2014) must be granted to small businesses under the SBIR/STTR program. As of 2011 , the extramural funding consisted of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions. By 2018 , this rate of granting remained reasonably steady, at 47,000 grants to 2,700 organizations. In FY 2010 , NIH spent US$ 10.7bn (not including temporary funding from
575-508: A clinical trial, except for the most critically ill, as determined by the NIH Director. Over the last century, the responsibility to allocate funding has shifted from the OD and Advisory Committee to the individual ICs and Congress increasingly set apart funding for particular causes. In the 1970s, Congress began to earmark funds specifically for cancer research, and in the 1980s there was
690-707: A complex set of relationships between state and federal courts. Federal courts can sometimes hear cases arising under state law pursuant to diversity jurisdiction , state courts can decide certain matters involving federal law, and a handful of federal claims are primarily reserved by federal statute to the state courts. Both court systems have exclusive jurisdiction in some areas and concurrent jurisdiction in others. The U.S. Constitution safeguards judicial independence by providing that federal judges shall hold office "during good behavior"; in practice, this usually means they serve until they die, retire, or resign. A judge who commits an offense while in office may be impeached in
805-468: A diverse research portfolio in order to capitalize on major discoveries in a variety of fields such as cell biology, genetics, physics, engineering, and computer science. Fourth, address public health needs according to the disease burden (e.g., prevalence and mortality). And fifth, construct and support the scientific infrastructure (e.g., well-equipped laboratories and safe research facilities) necessary to conduct research. Advisory committee members advise
920-613: A few cases. The judicial power extends to cases arising under the Constitution, an Act of Congress ; a U.S. treaty ; cases affecting ambassadors , ministers and consuls of foreign countries in the U.S.; cases and controversies to which the federal government is a party; controversies between states (or their citizens) and foreign nations (or their citizens or subjects); and bankruptcy cases (collectively "federal-question jurisdiction"). The Eleventh Amendment removed from federal jurisdiction cases in which citizens of one state were
1035-757: A multi-institutional collaboration with NIH, PROMIS has advanced the consensus process within the field of PRO measurement through the involvement of the funded research collaborative in establishing a rigorous, systematic infrastructure for measure development and psychometric evaluation. PROMIS takes advantage of developments in technology, as well as advances in the sciences of psychometric, qualitative, cognitive, and health survey research, to create new models and methods for collecting PROs for use in clinical research and evaluation of medical care. PROMIS incorporates and translates cutting-edge science into practical, easy to use tools for clinicians: For example, PROMIS implements Computer Adaptive Test (CAT) software which tailors
1150-552: A rate similar to inflation since the 1970s, research funding for the NIH nearly tripled through the 1990s and early 2000s, but has remained relatively stagnant since then. By the 1990s, the NIH committee focus had shifted to DNA research and launched the Human Genome Project . The NIH Office of the Director is the central office responsible for setting policy for NIH, and for planning, managing, and coordinating
1265-400: A series of audit reports revealing that throughout the fiscal years 2000–2010, institutes under the aegis of the NIH did not comply with the time and amount requirements specified in appropriations statutes, in awarding federal contracts to commercial partners, committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress. The NIH
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#17327760295071380-523: A significant amount allocated for AIDS/HIV research. Funding for the NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. During the 1980s, President Reagan repeatedly tried to cut funding for research, only to see Congress partly restore funding. The political contention over NIH funding slowed the nation's response to the AIDS epidemic; while AIDS
1495-478: A single elected term." Under the Presentment Clause of Article I, a bill that passes both chambers of Congress shall be presented to the president, who may sign the bill into law or veto the bill by returning it to the chamber where it originated. If the president neither signs nor vetoes a bill "within ten Days (Sundays excepted) after it shall have been presented to him" it becomes a law without
1610-619: A special election can take place. The House and Senate each have particular exclusive powers. For example, the Senate must approve (give " advice and consent " to) many important presidential appointments, including cabinet officers, federal judges (including nominees to the Supreme Court), department secretaries (heads of federal executive branch departments), U.S. military and naval officers, and ambassadors to foreign countries. All legislative bills for raising revenue must originate in
1725-956: A state-of-the-science assessment system for self–reported health. PROMIS has self-reported health measures in the domains of physical health, mental health and social health for adult self-reported and pediatric-self and proxy-reported health. Under each main domain (physical health, mental health, social health) are sub-domains associated with symptoms, function, affect, behavior, cognition, relationships or function. The sub-domains developed as of November 2016 are listed below. Domains that are “PROMIS Profile Domains” are included in either PROMIS Adult Profile Instruments (PROMIS-29, PROMIS-43, PROMIS-57) and Pediatric or Parent Proxy Profile Instruments (PROMIS Pediatric/Parent Proxy 25, PROMIS Pediatric/Parent Proxy 37, PROMIS Pediatric/Parent Proxy 49). There are also Sexual Function and Satisfaction Profiles for adults. National Institutes of Health The National Institutes of Health , commonly referred to as NIH ,
1840-583: A strategic action plan for the international spread of PROMIS. In early 2013, PROMIS unveiled new materials to expand its outreach to researchers and clinicians: the PROMIS e-newsletter and two instructional videos series about PROMIS and Item Response Theory. In 2016, an updated PROMIS website at www.HealthMeasures.net was created to provide more information about measure selection, data collection tools, score calculation, score interpretation, item response theory, and support an online forum for posting questions to
1955-515: A trade embargo, declare war upon a foreign government that the President had recognized, or decline to appropriate funds for an embassy in that country." The president may also negotiate and sign treaties, but ratifying treaties requires the consent of two-thirds of the Senate. Article II's Appointments Clause provides that the president "shall nominate, and by and with the Advice and Consent of
2070-613: Is available to the general public whereas the individual-level data is accessible to researchers. According to the City Journal NIH denies access to such attributes as intelligence, education and health on the grounds that studying their genetic basis would be stigmatizing. The NIH partnered with Moderna in 2020 during the COVID-19 pandemic to develop a vaccine. The final phase of testing began on July 27 with up to 30,000 volunteers assigned to one of two groups—one receiving
2185-612: Is composed of 27 separate institutes and centers that conduct and coordinate biomedical research. These are: In addition, the National Center for Research Resources operated from April 13, 1962, to December 23, 2011. The Advanced Research Projects Agency for Health (ARPA-H) is an entity formerly within the Office of the United States Secretary of Health and Human Services , which was created by Congress in
2300-443: Is determined by the scientist. The total number of applicants has increased substantially, from about 60,000 investigators who had applied during the period from 1999 to 2003 to slightly less than 90,000 in who had applied during the period from 2011 to 2015. Due to this, the "cumulative investigator rate", that is, the likelihood that unique investigators are funded over a 5-year window, has declined from 43% to 31%. R01 grants are
2415-645: Is established in Article Two of the United States Constitution , which vests executive power in the president of the United States . The president is both the head of state (performing ceremonial functions) and the head of government (the chief executive). The Constitution directs the president to " take care that the laws be faithfully executed " and requires the president to swear or affirm to "preserve, protect and defend
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#17327760295072530-402: Is intended to prevent waste and fraud, protect civil liberties and individual rights, ensure executive compliance with the law, gather information for making laws and educating the public, and evaluate executive performance. It applies to cabinet departments, executive agencies, regulatory commissions, and the presidency. Congress's oversight function takes many forms: The executive branch
2645-604: Is one delegate each from Washington, D.C. , Guam , the Virgin Islands , American Samoa , the Commonwealth of the Northern Mariana Islands , and a resident commissioner from Puerto Rico . Unlike the U.S. Senate , all members of the U.S. House must be elected and cannot be appointed. In the case of a vacancy, the seat must be filled through a special election, as required under Article 1 of
2760-444: Is one initiative within this program. The PROMIS initiative develops and evaluates standard measures for key patient-reported health indicators and symptoms. Patient-reported measures such as pain, fatigue, emotional distress, and physical functioning complement clinical measures (e.g., x-rays and lab tests) by providing healthcare providers with information about what patients are able to do and how they feel. PROMIS has worked to unify
2875-551: Is requesting $ 2.5 billion for 2024. Source: United States government [REDACTED] [REDACTED] The federal government of the United States ( U.S. federal government or U.S. government ) is the common government of the United States , a federal republic located primarily in North America , comprising 50 states , five major self-governing territories , several island possessions , and
2990-532: Is the commander-in-chief of the armed forces . Under the Reception Clause , the president is empowered to "receive Ambassadors and other public Ministers"; the president has broad authority to conduct foreign relations, is generally considered to have the sole power of diplomatic recognition , and is the United States' chief diplomat, although the Congress also has an important role in legislating on foreign affairs, and can, for example, "institute
3105-794: Is the primary agency of the United States government responsible for biomedical and public health research. It was founded in 1887 and is now part of the United States Department of Health and Human Services . Many NIH facilities are located in Bethesda, Maryland , and other nearby suburbs of the Washington metropolitan area , with other primary facilities in the Research Triangle Park in North Carolina and smaller satellite facilities located around
3220-597: The American Recovery and Reinvestment Act of 2009 ) on clinical research , US$ 7.4bn on genetics -related research, US$ 6.0bn on prevention research, US$ 5.8bn on cancer, and US$ 5.7bn on biotechnology . In 2008 a Congressional mandate called for investigators funded by the NIH to submit an electronic version of their final manuscripts to the National Library of Medicine 's research repository, PubMed Central (PMC), no later than 12 months after
3335-509: The Consolidated Appropriations Act, 2022 . Modeled after DARPA , HSARPA , IARPA , and ARPA-E , it is intended to pursue unconventional research projects through methods not typically used by federal agencies or private sector companies. Secretary Xavier Becerra delegated ARPA-H to the NIH on May 24, 2022. It received $ 1 billion in appropriations in 2022, and $ 1.5 billion in 2023, and as of June 2023 it
3450-474: The Constitution , and this is the name that appears on money, in treaties, and in legal cases to which the nation is a party. The terms "Government of the United States of America" or "United States Government" are often used in official documents to represent the federal government as distinct from the states collectively. In casual conversation or writing, the term "Federal Government" is often used, and
3565-697: The Hygienic Laboratory , was established within the Marine Hospital Service , which at the time was expanding its functions beyond the system of Marine Hospitals into quarantine and research programs. It was initially located at the New York Marine Hospital on Staten Island . In 1891, it moved to the top floor of the Butler Building in Washington, D.C. In 1904, it moved again to a new campus at
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3680-775: The Old Naval Observatory , which grew to include five major buildings. In 1901, the Division of Scientific Research was formed, which included the Hygienic Laboratory as well as other research offices of the Marine Hospital Service. In 1912, the Marine Hospital Service became the Public Health Service (PHS). In 1922, PHS established a Special Cancer Investigations laboratory at Harvard Medical School . This marked
3795-532: The U.S. Tax Court , are specialized courts handling only certain kinds of cases, known as subject matter jurisdiction . The Bankruptcy Courts are supervised by the district courts, and, as such, are not considered part of the Article III judiciary. As such, their judges do not have lifetime tenure, nor are they Constitutionally exempt from diminution of their remuneration. The Tax Court is an Article I Court, not an Article III Court. The district courts are
3910-505: The United States District Courts , which are the general trial courts for federal law, and for certain controversies between litigants who are not deemed citizens of the same state, known as diversity jurisdiction . There are three levels of federal courts with general jurisdiction, which are courts that handle both criminal and civil suits between individuals. Other courts, such as the bankruptcy courts and
4025-914: The United States Postal Service (USPS), NASA , the Central Intelligence Agency (CIA), the Environmental Protection Agency (EPA), and the United States Agency for International Development (USAID). In addition, there are government-owned corporations , including the Federal Deposit Insurance Corporation and the National Railroad Passenger Corporation . The Judiciary, under Article III of
4140-713: The White House staff, the National Security Council , the Office of Management and Budget , the Council of Economic Advisers , the Council on Environmental Quality , the Office of the U.S. Trade Representative , the Office of National Drug Control Policy , and the Office of Science and Technology Policy . Outside of the EOP and the executive departments are a number of independent agencies . These include
4255-692: The Wuhan Institute of Virology (WIV)—which has been at the center of speculation since early 2020 that SARS-CoV-2 may have escaped in a lab incident. Under political pressure, the NIH withdrew funding to EcoHealth Alliance in July 2020. On February 13, 2012, the National Institutes of Health (NIH) announced a new group of individuals assigned to research pain. This committee is composed of researchers from different organizations and will focus to "coordinate pain research activities across
4370-508: The federal district (national capital) of Washington, D.C. , where the majority of the federal government is based. The U.S. federal government is composed of three distinct branches: legislative , executive , and judicial , whose powers are vested by the U.S. Constitution in the Congress , the president , and the federal courts , respectively. The powers and duties of these branches are further defined by acts of Congress, including
4485-568: The mRNA-1273 vaccine and the other receiving salt water injections—and continued until there had been approximately 100 cases of COVID-19 among the participants. In 2021, the NIH contributed $ 4,395,399 towards the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) program. Following the outbreak of the COVID-19 pandemic , NIH-funded EcoHealth Alliance has been the subject of controversy and increased scrutiny due to its ties to
4600-593: The militia , exercise exclusive legislation in the District of Columbia , regulate interstate commerce , and to make laws necessary to properly execute powers. Over the two centuries since the United States was formed, many disputes have arisen over the limits on the powers of the federal government. These disputes have often been the subject of lawsuits that have ultimately been decided by the United States Supreme Court . Congressional oversight
4715-577: The 21 drugs with the highest therapeutic impact on society introduced between 1965 and 1992, public funding was "instrumental" for 15. As of 2011 NIH-supported research helped to discover 153 new FDA-approved drugs, vaccines, and new indications for drugs in the 40 years prior. One study found NIH funding aided either directly or indirectly in developing the drugs or drug targets for all of the 210 FDA-approved drugs from 2010 to 2016. In 2015, Pierre Azoulay et al. estimated $ 10 million invested in research generated two to three new patents. Since its inception,
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4830-484: The 50 states is determined by state populations, and it is updated after each decennial U.S. Census. Each member serves a two-year term. In order to be elected as a representative, an individual must be at least 25 years of age, must have been a U.S. citizen for at least seven years, and must live in the state that they represent. In addition to the 435 voting members, there are six non-voting members, consisting of five delegates and one resident commissioner . There
4945-833: The Cabinet who are appointed by the president. These are the White House Chief of Staff, Administrator of the Environmental Protection Agency, Director of the Office of Management & Budget, United States Trade Representative, U.S. Ambassador to the United Nations, Chairman of the Council of Economic Advisers, and Administrator of the Small Business Administration. The heads of the 15 departments are chosen by
5060-826: The Center for Cancer Research, Office of Scientific Operations, Management Operations Support Branch, the division of Cancer Epidemiology and Genetics and the division of Cancer Treatment and Diagnosis. The National Institute of Environmental Health Sciences is located in the Research Triangle region of North Carolina . Other ICs have satellite locations in addition to operations at the main campus. The National Institute of Allergy and Infectious Diseases maintains its Rocky Mountain Labs in Hamilton, Montana , with an emphasis on BSL3 and BSL4 laboratory work. NIDDK operates
5175-470: The Civil War) or when states' rights proponents have succeeded in limiting federal power through legislative action, executive prerogative or by a constitutional interpretation by the courts. One of the theoretical pillars of the U.S. Constitution is the idea of " checks and balances " among the powers and responsibilities of the three branches of American government: the executive, the legislative, and
5290-510: The Congress. The United States Congress , under Article I of the Constitution, is the legislative branch of the federal government. It is bicameral , comprising the House of Representatives and the Senate . The U.S. House of Representatives is made up of 435 voting members, each of whom represents a congressional district in a state from where they were elected. Apportionment of seats among
5405-714: The Constitution of the United States." Legal scholars William P. Marshall and Saikrishna B. Prakash write of the Clause: "the President may neither breach federal law nor order their subordinates to do so, for defiance cannot be considered faithful execution. The Constitution also incorporates the English bars on dispensing or suspending the law, with some supposing that the Clause itself prohibits both." Many presidential actions are undertaken via executive orders , presidential proclamations , and presidential memoranda . The president
5520-705: The Constitution, explains and applies the laws. This branch does this by hearing and eventually making decisions on various legal cases. Article III section I of the Constitution establishes the Supreme Court of the United States and authorizes the United States Congress to establish inferior courts as their need shall arise. Section I also establishes a lifetime tenure for all federal judges and states that their compensation may not be diminished during their time in office. Article II section II establishes that all federal judges are to be appointed by
5635-497: The Constitution. Some make a case for expansive federal powers while others argue for a more limited role for the central government in relation to individuals, the states, or other recognized entities. Since the American Civil War , the powers of the federal government have generally expanded greatly, although there have been periods since that time of legislative branch dominance (e.g., the decades immediately following
5750-615: The Constitution; all other powers are reserved to the states and the people. The Constitution also includes the Necessary and Proper Clause , which grants Congress the power to "make all laws which shall be necessary and proper for carrying into execution the foregoing powers". Members of the House and Senate are elected by first-past-the-post voting in every state except Louisiana and Georgia , which have runoffs , and Maine and Alaska , which use ranked-choice voting . Congress has
5865-663: The Director. NIH submits its budget request to the Department of Health and Human Services (HHS), and the HHS considers this request as a portion of its budget. Many adjustments and appeals occur between NIH and HHS before the agency submits NIH's budget request to the Office of Management and Budget (OMB). OMB determines what amounts and research areas are approved for incorporation into the President's final budget. The President then sends NIH's budget request to Congress in February for
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#17327760295075980-582: The House and 19 in the Senate, plus 4 joint permanent committees with members from both houses overseeing the Library of Congress , printing, taxation, and the economy. In addition, each house may name special, or select, committees to study specific problems. Today, much of the congressional workload is borne by the subcommittees, of which there are around 150. The Constitution grants numerous powers to Congress. Enumerated in Article I, Section 8, these include
6095-425: The House of Representatives. The approval of both chambers is required to pass all legislation, which then may only become law by being signed by the president (or, if the president vetoes the bill, both houses of Congress then re-pass the bill, but by a two-thirds majority of each chamber, in which case the bill becomes law without the president's signature). The powers of Congress are limited to those enumerated in
6210-469: The House plus its two senators). The District of Columbia has a number of electoral votes "equal to the whole number of Senators and Representatives in Congress to which the District would be entitled if it were a State, but in no event more than the least populous State". A President may also be seated by succession . As originally drafted, there was no limit to the time a President could serve, however
6325-490: The Jewish Chronic Disease Hospital. When three doctors resigned after refusing to inject patients without their consent, the experiment gained considerable media attention. The NIH was a major source of funding for Southam's research and had required all research involving human subjects to obtain their consent prior to any experimentation. Upon investigating all of their grantee institutions,
6440-694: The NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIH Toolbox) are also supported through HealthMeasures. HealthMeasures aims to facilitate the dissemination, implementation, and self-sustainability of these four measurement systems. The HealthMeasures grant was awarded to Northwestern University with additional sites at American Institutes for Research, University of California, Los Angeles, University of California, San Diego, University of North Carolina, Chapel Hill, and University of Pittsburgh. PROMIS uses measurement science to create
6555-500: The NIH Toolbox was rolled out to the research community. NIH Toolbox assessments are based, where possible, on Item Response Theory and adapted for testing by computer. NIH sponsors the Database of Genotypes and Phenotypes (dbGaP), a repository of information produced by studies investigating the interaction of genotype and phenotype. The information includes phenotypes, molecular assay data, analyses and documents. Summary-level data
6670-461: The NIH budget doubled. For a time, funding essentially remained flat, and for seven years following the financial crisis, the NIH budget struggled to keep up with inflation. In 1999 Congress increased the NIH's budget by $ 2.3 billion to $ 17.2 billion in 2000. In 2009 Congress again increased the NIH budget to $ 31 billion in 2010. In 2017 and 2018, Congress passed laws with bipartisan support that substantially increasing appropriations for NIH, which
6785-437: The NIH but may apply for funding. Throughout the history of the NIH, the amount of funding received has increased, but the proportion to each IC remains relatively constant. The individual ICs then decide who will receive the grant money and how much will be allotted. Policy changes on who receives funding significantly affect researchers. For example, the NIH has recently attempted to approve more first-time NIH R01 applicants or
6900-420: The NIH discovered that the majority of them did not protect the rights of human subjects. From then on, the NIH has required all grantee institutions to approve any research proposals involving human experimentation with review boards. In 1967, the Division of Regional Medical Programs was created to administer grants for research for heart disease, cancer, and strokes . That same year, the NIH director lobbied
7015-429: The NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research, and 85 percent of all funding for health studies in universities. While government funding for research in other disciplines has been increasing at
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#17327760295077130-489: The NIH intramural research program has been a source of many pivotal scientific and medical discoveries. Some of these include: In September 2006, the NIH Blueprint for Neuroscience Research started a contract for the NIH Toolbox for the Assessment of Neurological and Behavioral Function to develop a set of state-of-the-art measurement tools to enhance collection of data in large cohort studies. Scientists from more than 100 institutions nationwide contributed. In September 2012,
7245-453: The NIH would take the balance of each study design into consideration when awarding grants. The announcement also stated that this rule would probably not apply when studying sex-specific diseases (for example, ovarian or testicular cancer). One of the goals of the NIH is to "expand the base in medical and associated sciences in order to ensure a continued high return on the public investment in research." Taxpayer dollars funding NIH are from
7360-423: The National Institute for General Medical Science awarded funding to 30% of applicants. NIH employs five broad decision criteria in its funding policy. First, ensure the highest quality of scientific research by employing an arduous peer review process. Second, seize opportunities that have the greatest potential to yield new knowledge and that will lead to better prevention and treatment of disease. Third, maintain
7475-408: The PRO assessment to the individual patient by selecting the most informative set of questions based on responses to previous questions. CAT questionnaires allow an accurate measurement of health status using the fewest possible questions. In November 2012, the PROMIS network held it first international strategy meeting with organizational partners from 8 European countries, China and Canada to develop
7590-629: The PROMIS user community. The PROMIS initiative is fulfilled by a network of primary research sites and coordinating centers that collaborate to develop the items and tools to measure PROs, and to evaluate the reliability and validity of these measures. Between 2004 and 2009, PROMIS consisted of a Statistical Coordinating Center, located at Evanston Northwestern Healthcare, and six research sites located at Duke University, University of North Carolina at Chapel Hill, University of Pittsburgh, Stanford University, Stony Brook University, and University of Washington. In 2010, NIH renewed funding for PROMIS and expanded
7705-439: The Phoenix Epidemiology and Clinical Research Branch in Phoenix, Arizona . As of 2017, 153 scientists receiving financial support from the NIH have been awarded a Nobel Prize and 195 have been awarded a Lasker Award . NIH devotes 10% of its funding to research within its own facilities (intramural research), and gives >80% of its funding in research grants to extramural (outside) researchers. Of this extramural funding,
7820-508: The Roadmap for Medical Research in 2004 to identify major opportunities for medical research and the development of new scientific expertise and technology that would lead to tangible benefits for patients. One of the programs within the Roadmap, Re-engineering the Clinical Research Enterprise, called for developing rigorous and systematic infrastructure for clinical research and for translating scientific discoveries into practical applications or tools that can be used by healthcare providers. PROMIS
7935-403: The Senate, shall appoint Ambassadors, other public Ministers and Consuls, Judges of the supreme Court, and all other Officers of the United States " while providing that "Congress may by Law vest the Appointment of such inferior Officers, as they think proper, in the President alone, in the Courts of Law, or in the Heads of Departments." These appointments delegate "by legal authority a portion of
8050-417: The Twenty-second Amendment, ratified in 1951, originally limits any president to serving two four-year terms (8 years); the amendment specifically "caps the service of a president at 10 years" by providing that "if a person succeeds to the office of president without election and serves less than two years, he may run for two full terms; otherwise, a person succeeding to office of president can serve no more than
8165-404: The U.S. Constitution. In contrast, the Senate is made up of two senators from each state, regardless of population. There are currently 100 senators (2 from each of the 50 states), who each serve six-year terms. Approximately one-third of the Senate stands for election every two years. If a vacancy occurs, the state governor appoints a replacement to complete the term or to hold the office until
8280-572: The United States. The NIH conducts its own scientific research through the NIH Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program. As of 2013 , the IRP had 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, translational, and clinical research, being the largest biomedical research institution in
8395-649: The White House for increased federal funding in order to increase research and the speed with which health benefits could be brought to the people. An advisory committee was formed to oversee the further development of the NIH and its research programs. By 1971 cancer research was in full force and President Nixon signed the National Cancer Act , initiating a National Cancer Program, President's Cancer Panel, National Cancer Advisory Board, and 15 new research, training, and demonstration centers. Funding for
8510-692: The beginning of a partnership with universities. In 1930, the Hygienic Laboratory was re-designated as the National Institute of Health by the Ransdell Act , and was given $ 750,000 to construct two NIH buildings at the Old Naval Observatory campus. In 1937, NIH absorbed the rest of the Division of Scientific Research, of which it was formerly part. In 1938, NIH moved to its current campus in Bethesda, Maryland . Over
8625-402: The case from state court to federal court. The United States Courts of Appeals are appellate courts that hear appeals of cases decided by the district courts, and some direct appeals from administrative agencies, and some interlocutory appeals. The U.S. Supreme Court hears appeals from the decisions of the courts of appeals or state supreme courts, and in addition has original jurisdiction over
8740-404: The chambers to consider urgent matters. The vice president is the second-highest official in rank of the federal government. The vice president's duties and powers are established in the legislative branch of the federal government under Article 1, Section 3, Clauses 4 and 5 as the president of the Senate ; this means that they are the designated presiding officer of the Senate. In that capacity,
8855-440: The creation of executive departments and courts subordinate to the U.S. Supreme Court . In the federal division of power, the federal government shares sovereignty with each of the 50 states in their respective territories. U.S. law recognizes Indigenous tribes as possessing sovereign powers , while being subject to federal jurisdiction. The full name of the republic is the "United States of America". No other name appears in
8970-473: The creation of vaccines against hepatitis , Haemophilus influenzae (HIB), and human papillomavirus (HPV). In 2019, the NIH was ranked number two in the world, behind Harvard University , for biomedical sciences in the Nature Index , which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018. In 1887, a laboratory for the study of bacteria,
9085-418: The executive branch when becoming president upon the death, resignation, or removal of the president, which has happened nine times in U.S. history. Lastly, in the case of a Twenty-fifth Amendment succession event, the vice president would become acting president, assuming all of the powers and duties of president, except being designated as president. Accordingly, by circumstances, the Constitution designates
9200-522: The federal government with the goals of stimulating pain research collaboration… and providing an important avenue for public involvement" ("Members of new", 2012). With a committee such as this research will not be conducted by each individual organization or person but instead a collaborating group which will increase the information available. With this hopefully more pain management will be available including techniques for those with arthritis. In 2020 Beth Darnall , American scientist and pain psychologist,
9315-429: The field of patient-reported outcome (PRO) measurement through the promotion of a common, systematic measurement system broadly applicable across clinical research. PROMIS measures are intended to assess the most common or salient dimensions of patient–relevant outcomes for the widest possible range of chronic disorders and diseases, thus they are "generic" measures vs. specific to given disease or condition. Structured as
9430-531: The general population. Further, PROMIS tools allow for computer adaptive testing, efficiently achieving precise measurement of health status domains with few items. There are PROMIS measures for both adults and children. PROMIS was established in 2004 with funding from the National Institutes of Health (NIH) as one of the initiatives of the NIH Roadmap for Medical Research. The NIH established
9545-489: The institute on policy and procedures affecting the external research programs and provide a second level of review for all grant and cooperative agreement applications considered by the Institute for funding. In 2014, it was announced that the NIH is directing scientists to perform their experiments with both female and male animals, or cells derived from females as well as males if they are studying cell cultures, and that
9660-483: The judiciary. For example, while the legislative branch ( Congress ) has the power to create law, the executive branch under the president can veto any legislation—an act which, in turn, can be overridden by Congress. The president nominates judges to the nation's highest judiciary authority, the Supreme Court (as well as to lower federal courts), but those nominees must be approved by Congress. The Supreme Court, in turn, can invalidate unconstitutional laws passed by
9775-486: The law and creating precedent for future law and decisions. The United States Constitution does not specifically mention the power of judicial review , which is the power to declare a law unconstitutional. There have been instances in the past where such declarations have been ignored by the other two branches. Below the U.S. Supreme Court are the United States Courts of Appeals , and below them in turn are
9890-530: The most common funding mechanism and include investigator-initiated projects. The roughly 27,000 to 29,000 R01 applications had a funding success of 17-19% during 2012 though 2014. Similarly, the 13,000 to 14,000 R21 applications had a funding success of 13-14% during the same period. In FY 2016, the total number of grant applications received by the NIH was 54,220, with approximately 19% being awarded funding. Institutes have varying funding rates. The National Cancer Institute awarded funding to 12% of applicants, while
10005-653: The next few decades, Congress would markedly increase funding of the NIH, and various institutes and centers within the NIH were created for specific research programs. In 1944, the Public Health Service Act was approved, and the National Cancer Institute became a division of NIH. In 1948, the name changed from National Institute of Health to National Institutes of Health. In the 1960s, virologist and cancer researcher Chester M. Southam injected HeLa cancer cells into patients at
10120-466: The next fiscal year's allocations. The House and Senate Appropriations Subcommittees deliberate and by fall, Congress usually appropriates funding. This process takes approximately 18 months before the NIH can allocate any actual funds. When a government shutdown occurs, the NIH continues to treat people who are already enrolled in clinical trials , but does not start any new clinical trials and does not admit new patients who are not already enrolled in
10235-702: The office of vice president. Article II, Section 2 of the Constitution sets forth the creation of a presidential Cabinet. The role of the Cabinet is to advise the president and carry out the programs and laws of the federal government. The Cabinet is composed of the vice president and the leaders of 15 executive departments. Those executive departments are the Departments of State, Treasury, Defense, Justice, Interior, Agriculture, Commerce, Labor, Health and Human Services, Housing and Urban Development, Transportation, Energy, Education, Veterans Affairs, and Homeland Security. Additionally, there are seven other members of
10350-539: The official date of publication. The NIH Public Access Policy was the first public access mandate for a U.S. public funding agency. In 2000, the Joint Economic Committee of Congress reported NIH research, which was funded at $ 16 billion a year in 2000, that some econometric studies had given a rate of return of 25 to 40 percent per year by reducing the economic cost of illness in the US. It found that of
10465-488: The plaintiffs and the government of another state was the defendant. It did not disturb federal jurisdiction in cases in which a state government is a plaintiff and a citizen of another state the defendant. The power of the federal courts extends both to civil actions for damages and other redress, and to criminal cases arising under federal law. The interplay of the Supremacy Clause and Article III has resulted in
10580-497: The power to adjourn Congress whenever the House and Senate cannot agree when to adjourn; no president has ever used this power. The president also has the constitutional power to, "on extraordinary Occasions, convene both Houses, or either of them"; this power has been used "to consider nominations, war, and emergency legislation." This Section invests the President with the discretion to convene Congress on "extraordinary occasions"; this special session power that has been used to call
10695-478: The power to re-organize or even abolish federal courts lower than the Supreme Court. The U.S. Supreme Court decides cases and controversies , which include matters pertaining to the federal government, disputes between states, and interpretation of the United States Constitution, and, in general, can declare legislation or executive action made at any level of the government as unconstitutional , nullifying
10810-437: The power to remove the president, federal judges, and other federal officers from office. The House of Representatives and Senate have separate roles in this process. The House must first vote to impeach the official. Then, a trial is held in the Senate to decide whether the official should be removed from office. As of 2023 , three presidents have been impeached: Andrew Johnson , Bill Clinton , and Donald Trump (twice). None of
10925-420: The powers to levy and collect taxes ; to coin money and regulate its value; provide for punishment for counterfeiting; establish post offices and roads, issue patents, create federal courts inferior to the Supreme Court , combat piracies and felonies , declare war , raise and support armies , provide and maintain a navy , make rules for the regulation of land and naval forces, provide for, arm and discipline
11040-502: The president and approved with the "advice and consent" of the U.S. Senate. Once confirmed, these "Cabinet secretaries" serve at the pleasure of the president. In addition to the executive departments, a number of staff organizations are grouped into the Executive Office of the President (EOP), which was created in 1939 by President Franklin D. Roosevelt. The EOP is overseen by the White House Chief of Staff. The EOP includes
11155-485: The president and confirmed by the United States Senate. The Judiciary Act of 1789 subdivided the nation jurisdictionally into judicial districts and created federal courts for each district. The three tiered structure of this act established the basic structure of the national judiciary: the Supreme Court, 13 courts of appeals, 94 district courts, and two courts of special jurisdiction. Congress retains
11270-474: The president has major agenda-setting powers to influence lawmaking and policymaking, and typically has a major role as the leader of their political party . The president and vice president are normally elected as running mates by the Electoral College ; each state has a number of electoral votes equal to the size of its Congressional delegation ( i.e. , its number of Representatives in
11385-525: The president's signature, "unless the Congress by their Adjournment prevent its Return in which Case it shall not be a Law" (called a pocket veto ). A presidential veto may be overridden by a two-thirds vote in both houses of Congress; this occurs relatively infrequently. The president may be impeached by a majority in the House and removed from office by a two-thirds majority in the Senate for " treason , bribery , or other high crimes and misdemeanors ". The president may not dissolve Congress , but has
11500-493: The program to six additional research sites: Children's Hospital of Philadelphia; Boston University / University of Michigan, Ann Arbor; University of California, Los Angeles; Georgetown University; Children's Hospital Medical Center, Cincinnati; and University of Maryland, Baltimore. PROMIS also added a Network Center, operated by the American Institutes for Research, Washington DC as well as a Statistical Center and
11615-599: The programs and activities of all NIH components. The NIH Director plays an active role in shaping the agency's activities and outlook. The Director is responsible for providing leadership to the Institutes and Centers by identifying needs and opportunities, especially in efforts involving multiple Institutes. Within the Director's Office is the Division of Program Coordination, Planning and Strategic Initiatives with 12 divisions including: The Agency Intramural Research Integrity Officer "is directly responsible for overseeing
11730-468: The research grant applications of young scientists. To encourage the participation of young scientists, the application process has been shortened and made easier. In addition, first-time applicants are being offered more funding for their research grants than those who have received grants in the past. In 2011 and 2012, the Department of Health and Human Services Office of Inspector General published
11845-517: The resolution of all research misconduct allegations involving intramural research , and for promoting research integrity within the NIH Office of Intramural Research (OIR)." There is a Division of Extramural Activities, which has its own Director. The Office of Ethics has its own Director, as does the Office of Global Research. Intramural research is primarily conducted at the main campus in Bethesda, Maryland , and Rockville, Maryland , and
11960-594: The sovereign powers of the federal government." The Constitution grants the president the "Power to grant Reprieves and Pardons for Offences against the United States , except in Cases of Impeachment"; this clemency power includes the power to issue absolute or conditional pardons, and to issue commute sentences , to remit fines, and to issue general amnesties . The presidential clemency power extends only to federal crimes, and not to state crimes. The president has informal powers beyond their formal powers. For example,
12075-617: The surrounding communities. The Bayview Campus in Baltimore , Maryland houses the research programs of the National Institute on Aging , National Institute on Drug Abuse , and National Human Genome Research Institute with nearly 1,000 scientists and support staff. The Frederick National Laboratory in Frederick, MD and the nearby Riverside Research Park, houses many components of the National Cancer Institute , including
12190-533: The taxpayers, making them the primary beneficiaries of advances in research. Thus, the general public is a key stakeholder in the decisions resulting from the NIH funding policy. However, some in the general public do not feel their interests are being represented, and individuals have formed patient advocacy groups to represent their own interests. Important stakeholders of the NIH funding policy include researchers and scientists. Extramural researchers differ from intramural researchers in that they are not employed by
12305-467: The term "U.S. Government" is sometimes used. The terms "Federal" and "National" in government agency or program names generally indicate affiliation with the federal government; for instance, the Federal Bureau of Investigation , National Oceanic and Atmospheric Administration , and National Park Service . Because the seat of government is in Washington, D.C. , "Washington" is sometimes used as
12420-434: The three were removed from office following trial in the Senate. Article I, Section 2, paragraph 2 of the U.S. Constitution gives each chamber the power to "determine the rules of its proceedings". From this provision were created congressional committees , which do the work of drafting legislation and conducting congressional investigations into national matters. The 118th Congress (2023–2025) has 20 standing committees in
12535-529: The trial courts wherein cases that are considered under the Judicial Code (Title 28, United States Code) consistent with the jurisdictional precepts of federal question jurisdiction , diversity jurisdiction, and pendent jurisdiction can be filed and decided. The district courts can also hear cases under removal jurisdiction , wherein a case brought in a state court meets the requirements for diversity jurisdiction, and one party litigant chooses to "remove"
12650-518: The vice president as routinely in the legislative branch, or succeeding to the executive branch as president, or possibly being in both as acting president pursuant to the Twenty-fifth Amendment . Because of circumstances, the overlapping nature of the duties and powers attributed to the office, the title of the office and other matters, such has generated a spirited scholarly dispute regarding attaching an exclusive branch designation to
12765-522: The vice president has the authority ( ex officio , for they are not an elected member of the Senate) to cast a tie-breaking vote . Pursuant to the Twelfth Amendment , the vice president presides over the joint session of Congress when it convenes to count the vote of the Electoral College . As first in the U.S. presidential line of succession , the vice president's duties and powers move to
12880-414: The world, while, as of 2003, the extramural arm provided 28% of biomedical research funding spent annually in the U.S., or about US$ 26.4 billion. The NIH comprises 27 separate institutes and centers of different biomedical disciplines and is responsible for many scientific accomplishments, including the discovery of fluoride to prevent tooth decay , the use of lithium to manage bipolar disorder , and
12995-670: Was 37.3 billion dollars annually in FY2018. Researchers at universities or other institutions outside of NIH can apply for research project grants (RPGs) from the NIH. There are numerous funding mechanisms for different project types (e.g., basic research, clinical research, etc.) and career stages (e.g., early career, postdoc fellowships, etc.). The NIH regularly issues "requests for applications" (RFAs), e.g., on specific programmatic priorities or timely medical problems (such as Zika virus research in early 2016). In addition, researchers can apply for "investigator-initiated grants" whose subject
13110-455: Was appointed as scientific member of the group. To allocate funds, the NIH must first obtain its budget from Congress. This process begins with institute and center (IC) leaders collaborating with scientists to determine the most important and promising research areas within their fields. IC leaders discuss research areas with NIH management who then develops a budget request for continuing projects, new research proposals, and new initiatives from
13225-576: Was reported in newspaper articles from 1981, no funding was provided for research on the disease. In 1984 National Cancer Institute scientists found implications that "variants of a human cancer virus called HTLV-III are the primary cause of acquired immunodeficiency syndrome (AIDS)," a new epidemic that gripped the nation. In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research and 85 percent of all funding for health studies in universities. From 1993 to 2001
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