The American College of Chest Physicians (CHEST) submitted comments to the Office of Management and Budget (OMB) on proposed revisions to federal policies governing research grants, cooperative agreements, and other forms of federal financial assistance.
While supporting greater transparency and accountability, CHEST emphasized that policy changes should strengthen the scientific foundation that enables medical discovery, rather than disrupt the research continuum that leads to better patient care.
According to the OMB, the proposed rule would ensure that federal funding is used responsibly, recipients are held accountable for meeting program requirements, unlawful discrimination is prohibited, and unnecessary burden is reduced. CHEST agrees these are important objectives but concluded that several proposed changes could complicate decision-making and make the continuity of scientific discovery more vulnerable to shifting governmental priorities, ultimately weakening the evidence needed to improve patient care.
“Scientific instability is not an abstract governance concern for patients with respiratory disease and critical illness. It carries direct consequences for patient care,” said Robert Musacchio, PhD, Chief Executive Officer and Executive Vice President of CHEST.
Transformative advances in pulmonary, critical care, and sleep medicine often require decades of sustained investigation—from foundational laboratory discoveries to clinical trials, regulatory review, and implementation in clinical practice. Stable funding and predictable government oversight are essential throughout that process. Disruptions to clinical trials or longitudinal studies can invalidate years of research, waste valuable scientific and financial resources, expose participants to unnecessary risk, and prevent the generation of the evidence that patients and clinicians alike rely on to improve future patient care.
CHEST issued a section-by-section response to the rule proposal using the following principles to guide its recommendations:
Every clinical guideline, new therapy, and evidence-based recommendation begins with research. Federal policies that promote both accountability and scientific excellence help ensure that clinicians continue to have access to the evidence they need to provide the highest-quality care.
By participating in the federal rulemaking process, CHEST is working to secure reforms that strengthen public trust while preserving the research ecosystem that generates the evidence on which innovation in pulmonary, critical care, and sleep medicine depends.
Patients benefit when research is rigorous, collaborative, and focused on generating evidence that improves care. Policies should strengthen the scientific enterprise on which clinicians rely to deliver the best possible care, not disrupt it.
To that end, CHEST will continue to advocate for federal policies that promote rigorous science, responsible stewardship of public resources, and continued medical innovation that improves patient outcomes.