Diagnostic errors account for almost 60 percent of all medical errors and an estimated 40,000-80,000 deaths per year. Three clinical conditions – cancer, acute cardiovascular events, and sepsis – provide a useful lens for exploring these pre-hospital diagnostic delays.
The burden of these conditions falls disproportionately on communities of color and on populations in underserved urban and rural communities. These disparities manifest in worse outcomes and greater than average severity at the time of diagnosis for some populations, suggesting that delays are also more common among these populations. Because cancer, acute cardiovascular events, and sepsis have relatively effective treatments when caught early enough, minimizing the time to diagnosis after the onset of symptoms is fundamental to high-quality care.
Call for Proposals
AcademyHealth in partnership with the Gordon and Betty Moore Foundation is funding health services research projects to expand the base of rigorous evidence about pre-hospital diagnostic delays – i.e., those that occur before a patient reaches the care setting where their condition is diagnosed. This call for proposals will fund innovative studies that expand our understanding of the causes of pre-hospital diagnostic delays or provide evidence about promising strategies to reduce them.
More information on pre-hospital diagnostic delay is available in this recent issue brief from AcademyHealth and a meeting summary from "Decoding the Signal from the Noise: Building the Evidence Base to Prevent Pre-Hospital Diagnostic Delays".
The call for proposals is now closed.
Key Dates:
Webinar for Potential Applicants: Thursday, February 2, 2023 at 12:00 p.m. ET
Call for Proposals opens: Tuesday, February 7, 2023 at 9:00 a.m. ET
Brief proposals due: Tuesday, March 21, 2023 at 3:00 p.m. ET
Applicants notified if they are (or are not) invited to submit full proposals: Tuesday, May 23, 2023
Full proposal submission deadline: Friday, June 30, 2023 at 3:00 p.m. ET
Full Proposal Applicants Notified if Their Projects Are Funded: By October 15, 2023
Expected Start Date for Funded Projects: November 1, 2023
Additional Resources for Prospective Applicants
- America’s Emergency Medical Service System
By: Emily B. Brant, M.D., M.S.
- Pre-Hospital Delay in the Diagnosis of Acute Cardiovascular Events: What Do We Know?
By: Sameed Ahmed M. Khatana, M.D., M.P.H.
- Pre-Hospital Diagnostic Interval in Cancer Diagnosis: What Do We Know?
By: Lesleigh A. Kowalski and Matthew J. Thompson
- How Could “Real World Data” Help Us Better Understand Pre-hospital Diagnostic Delay?
By: Elaine O. Nsoesie
- Role of Behavioral Economics in Pre-Hospital Diagnostic Delay
By: Patrycja Sleboda, Ph.D. and Michael Sobolev, Ph.D.
Frequently Asked Questions
1. What are considered allowable expenses?
Please refer to the Gordon and Betty Moore Foundation’s Grantee Resources page. The indirect cost policy can be accessed here.
2. Is staff time covered in the expenses?
Yes, both faculty and staff support are permissible expenses.
3. What does “pre-hospital” mean?
Pre-hospital includes delays in diagnosis that occur before a patient reaches the care setting where their condition is diagnosed. This may include clinical visits, such as an ED or primary care encounter that does not ultimately end in a diagnosis or referral to a setting where the patient can be accurately diagnosed.
4. Are projects that examine delays that occur in urgent care centers or emergency departments considered “pre-hospital” in the diagnosis of cancer?
We define “pre-hospital” delays to be those that occur before a patient reaches the care setting where their condition is ultimately diagnosed. Since cancer diagnosis usually requires referral from a facility where the condition is suspected, studies examining delays that occur in these particular settings would likely be in-scope for this grant solicitation.
5. Are studies that use insurance claims data permitted?
Yes
6. Are mixed methods studies permitted?
Yes
7. Are references necessary for the brief proposal stage?
References are not necessary for the brief proposal stage. If you would like to include references, they should be cited as footnotes within the 4-page maximum.
8. What should we include under “Project summary and Potential Impact of Findings?”
There is a 1500-character limit for this section, in which we are asking for an abstract where you describe the project’s importance, relevance, and why the project should be funded as concisely as possible. You can also include the project methods and data, although there will be opportunities to do this in more detail in the brief proposal narrative.
9. This call for proposal only allows studying sepsis, cancer, and acute cardiovascular events, or could COVID be regarded as a suitable topic?
The CFP centers on the three sentinel conditions the questioner mentions, but the Gordon and Betty Moore’s Diagnostic Excellence program is actually interested in serious infections more broadly. In addition, we recognize that COVID-19 can give rise to sepsis and/or complicate the diagnostic journey for patients with one or more of the three conditions of interest. For this CFP, studies that examine COVID-19 alongside one of the other three conditions, or that have direct relevance to understanding or addressing pre-hospital delays in the diagnosis of one of the three conditions would be considered within the scope of this solicitation.
10. Are figures or tables allowed in the brief proposal?
Detailed data and figures are not required at the brief proposal level. If you include them, they should be within the 4-page limit of the proposal narrative. Applicants invited to submit a full proposal will have an opportunity to share additional materials that help make the case for their research projects.
11. Who should you identify under "Grant signer" if you work at a university? Should this be the Principle Investigator or the grant official?
The grant signer should be the grant official at your university.
12. Are Co-primary Investigators or Mentor salaries allowable expenses?
Yes, staff support is an allowable expense for the project funds.
13. Is the budget estimate included in the four-page limit, or is that separate from the four-page limit?
At this stage in the proposal, we do not need a detailed budget estimate, just an estimate of the amount of funds you are requesting. At the next stage, we will ask applicants for a more detailed budget breakdown.
14. Does the number of pages submitted have a hard cap of 4 pages? Or can references be put on a 5th page?
There is a strict 4-page limit with the spacing and font styles noted in the instructions. However, references are not necessary or expected at the brief proposal stage. Those researchers invited to submit a full proposal will have the opportunity to include a reference list in addition to a 10-page narrative.
15. Is the $150,000 budget maximum a total cost maximum or a direct cost maximum?
The maximum $150,000 includes both direct and indirect costs, not just direct costs. You can find more detail about the Gordon and Betty Moore Foundation's indirect cost policy at https://www.moore.org/grants/grantee-resources.
16. Can applicants from outside of the United States apply?
This call for proposals requires applicants to be based in the U.S. or its territories.
17. How do I upload the separate document of references? It allows for only one file to be uploaded. Or should I upload a combined document?
References are not necessary for the brief proposal stage. If you would like to include references, they should be cited as footnotes within the 4-page maximum.
For other questions, please contact dxdelay@academyhealth.org.