Health Services Research (HSR) Methods
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Hypothetical 3: The Peer Reviewer

In response to a call for proposals, the Fine Foundation has received 20 proposals. They ask Bill Brainer, an established health services researcher, to serve on a panel of reviewers who will evaluate the proposals and make funding recommendations. The panel members are asked to provide an independent assessment of each proposal. As Brainer reviews the proposals, he comes across one submitted by Ann Andrews, who he knows quite well. Andrews works at a health policy organization where Brainer hopes to get a job. The proposal is decent but not stellar and not as good as many of the others submitted. Brainer knows that if Andrews’ health policy organization receives this award, they could be more inclined to offer him a position there, particularly if he lets on that he was a reviewer. Brainer takes a break from reading proposals and goes down to the local pub. He sees a colleague, Carol Cole, who is also on the review panel. Brainer and Cole launch into a discussion about the various proposals. Brainer begins a hard sell to try and get Cole to support the Andrews proposal. Cole has actually been thinking about developing a similar project idea. Having read the Andrews proposal, she knows that it contains fatal flaws and has no intention of supporting it. However, it has given her some critical ideas on how to better shape her own project. She ignores Brainer’s plug for the proposal; recommends a turndown, but uses ideas from the Andrews proposal to begin reshaping her own project, which she will submit to the Gold Foundation in a few months.


A.    What obligation does Brainer have to disclose to the Fine Foundation that his friend’s proposal is among those he 
        is being asked to review and then to recuse himself from the review? 
B.    In the small health services research community, where do peer reviewers have to draw the line? Is the potential 
        for a perceived conflict of interest a good barometer when deciding whether to accept a request to serve as a reviewer?
C.    Is it unethical for Brainer to consider his own interests and career potential as he evaluates a proposal from an 
        organization where he hopes to work? 
D.    What is Cole’s obligation? Should she disclose to Fine Foundation that there may not be complete objectivity among 
        the review panelists? 
E.    Where does Cole cross the line in terms of developing her own project based on what she learns from reading the 
       Andrews proposal? If the Andrews proposal is flawed and is not ultimately funded, is Cole wrong to “use” it to develop 
       her own project idea?

For further discussion of these questions, please join the Hypothetical 3: The Peer Reviewer forum.