William Oldendorf, M.D., discovery of the principle of compu- 

 Icrized axial tomography (CAT). 



Rohert O. Becker. M.D.. electrical control of mammalian tissue 

 regeneration. • 



Thomas P. Singer. Ph.D., biological energy generation and mi- 

 tochondrial biogenesis. 



Paul A. Srere, Ph.D., citrate metabolism and cellular adhesion. 



John W. Porter, Ph.D., lipid synthesis. 



Robert Efron, M.D., temporal aspects of auditory perception. 



Rosalyn S. Yallow, Ph.D. and Solomon A. Berson, M.D. 

 (dec), development of radioimmunoassay. 



Current and Future Research 

 Emphasis 



The VA will continue to support intramural 

 basic biomedical research. It currently is especially 

 interested in dedifferentiation and redifferentiation 

 of neural tissue, the biochemical and structural 

 changes of aging, and the metabolic basis of alco- 

 holism. There is no intention to broaden the scope 

 of the basic research beyond the present relatively 

 narrow, mandated limits. 



Organization and IVIanagement of 

 Scientific Activities 



Management Structure 



Research in the VA is largely decentralized, as 

 well as intramural and investigator-initiated. There 

 is, therefore, a research organization within each 

 participating VA health care facility in addition to 

 a research and development office in the VA Cen- 

 tral Office. 



The usual hospital organization includes an As- 

 sociate Chief of Staff for Research and Develop- 

 ment (ACOS) charged with administering the local 

 program. A Research and Development (R&D) 

 Committee, composed chiefly of health care facili- 

 ty staflF members, acts as a reviewing, evaluating, 

 and executive body. It usually includes faculty 

 members of an affiliated medical school and uses 

 outside consultants for scientific evaluation. A 

 Human Studies Subcommittee and an Animal 

 Studies Subcommittee review all research propos- 

 als for work in their respective areas; other sub- 

 committees are created as needed. 



The Office of the Assistant Chief Medical Direc- 

 tor for Research and Development in the VA Cen- 

 tral Office contains three Services: the Medical 

 Research Service, the Rehabilitative Engineering 

 Research and Development Service, and Health 



Services Research and Development Service. Ba- 

 sic science is almost exclusively under the aegis of 

 the Medical Research Service. 



This Service uses three mechanisms to assess 

 basic research proposals and the progress made 

 under them: Evaluation by an appropriate expert 

 from within or outside the VA; review by a Re- 

 search Advisory Group; and evaluation by a Merit 

 Review Board. 



There are four Research Advisory Groups, each 

 with three VA professional staff members, an 

 ACOS, an investigator, and a clinician. Each 

 Group considers applications for one-time research 

 funding from a health care facility located in a part 

 of the country from which its members are not 

 drawn. In order to provide specialized evaluation, 

 the Medical Research Service arranges for review 

 of each application by a VA scientist who is expert 

 in the relevant research field before the Group 

 considers it. 



Each Merit Review Board, in contrast, deals 

 with one area of medicine or science and the pre- 

 ponderance of its members comes from outside the 

 VA. The members are chosen for their scientific 

 expertise and research experience so that addition- 

 al technical opinions are needed only occasionally. 



The senior staff of the Medical Research Service 

 acts as an administrative reviewing body for the 

 programs evaluated by the Regional Advisory 

 Groups and the Merit Review Boards. This allows 

 separate consideration of scientific merit and of 

 relevance to the VA's mission. 



Initiation and Review of Basic Research 

 Projects 



Basic research projects are proposed by VA 

 investigators themselves, then are developed and 

 presented in writing by them to the R&D Commit- 

 tee of the investigator's hospital. Any proposal to 

 use animal subjects must be approved as reasona- 

 ble and ethical by the Animal Research Subcom- 

 mittee; any involving human subjects must satisfy 

 the Human Studies Subcommittee that the 

 integrity and rights of the subject are protected. 

 The R&D Committee can obtain evaluation of the 

 proposal by an expert before deciding whether to 

 .support it. 



Large programs must be submitted through the 

 VA Central Office's Medical Research Service to 

 Merit Review Boards after R&D Committee ap- 

 proval. The Board recommends on scientific 

 grounds that the program should be approved or 

 disapproved and if approved, assigns it a priority 

 rating as well as commenting on its funding. Gen- 

 erally, approvals are for four years or less at which 

 time the Merit Review Board evaluates the pro- 

 gress and proposed future course of the research. 



VETERANS ADMINISTRATION 231 



