Thought exercises on accountability and performance measures at the National Heart, Lung, and Blood Institute (NHLBI): an invited commentary for circulation research.

Recently, popular magazines and newspapers broadcast skeptical headlines, such as, “Desperately Seeking Cures”1; “A Decade Later, Genetic Map Yields Few Cures”2; “Faltering Cancer Trials”3; and “Grant System Leads Cancer Researchers to Play It Safe.”4 Some patients, physicians, advocacy groups, journalists, scholars, and policymakers openly wonder about the value of billions of dollars in government-supported research. During the past 10 years, the NIH budget has doubled, yet cardiovascular disease, while decreasing in incidence and severity, is still the leading cause of death and cancer incidence and death rates have declined little. Along with “Where Are the Cures?” critics ask “Who Is Accountable?”5