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In support of the AcademyHealth Paradigm Project, this horizon scan reviews options for innovating the research funding processes.

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Like many fields, health services research relies on peer review to assure rigor and relevance. However, evidence demonstrates that the current approach is time-consuming for both researchers and reviewers, has limited power to predict research outcomes, and is subject to conservatism, inconsistent results, and potential bias. Lotteries, self-review, open peer review, innovation prizes, and other approaches have emerged as potential alternatives, but each of these options comes with its own advantages and disadvantages.

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