Bringing Common Sense to Medical Research

When Phil Skiff sits down to review grant applications for the Congressionally Directed Medical Research Programs (CDMRP), he’s typically the only person in the room without a PhD.

“There are all these scary-smart people, and then there’s me—Joe Blow off the street,” laughs Skiff, a retired IT consultant. “Honestly, it is a little intimidating. They’re talking about things I can’t even begin to understand.”

But Skiff understands one critical thing better than any of his colleagues: limb loss. A below-knee amputee since 2008, he’s more qualified than any brainiac to assess the real-world importance of research proposals involving prosthetic technology or amputee care. Skiff contributes practical expertise that can’t be cultivated in a lab, clinic, or library—and that the CDMRP can’t function without. 

“My role is to review the impact statement that’s included in the application,” he explains. “That’s where they say how their project is going to benefit people and change lives.”

Established in 1992 and operated by the Army, the CDMRP supports pioneering biomedical research that’s too speculative to attract funding from other sources. Applicants include university labs, hospitals, corporate product developers, startup firms, and nonprofit agencies. Prosthetics/orthotics is one of the CDMRP’s 30-plus focus areas, all of which rely on patient advocates to identify worthy projects.

Skiff was recruited to the CDMRP a few years ago after participating in clinical trials related to the BiOM powered ankle. Although confidentiality rules prevent him from discussing specific applications that he’s reviewed, Skiff can describe them in general terms.

“Some of the things that have been really exciting are new surgical techniques,” he says. “One that I was very familiar with, because I actually had this problem myself, is for dealing with neuromas. New technologies for socket interfaces, like pressure sensors and other things that can auto-adjust the fit, are also exciting for me because I’ve always had significant volume-change issues and skin breakdown. The possibility of having that adjustment being done dynamically could make a big difference.”

Skiff can articulate the importance of relatively simple or arcane innovations that might otherwise get dismissed, such as moisture-wicking mechanisms inside a socket. And his opinions carry just as much weight as the most academically imposing reviewers. “I’m treated as a peer among these people,” he says. “We all turn in our scores [for each application], and mine are weighed as heavily as the senior scientist on the panel. It’s amazing.”

Asked to name a limb-care research frontier that he’d like to see grant applications for, Skiff cites osseointegration. “That has the potential for game-changing life impact on amputees, if they can eliminate the infection issues,” he says. Skiff adds that the CDMRP is constantly looking for citizen advocates to participate on grant-review panels. “It’s not for everyone, because you have to sit down and review 50-page applications—not an easy task,” he says. “But the patient voice has to be in there. Somebody has to be part of the discussion and take part in the decision-making.”

To learn more about the CDMRP, visit Read our full interview with Skiff at this link.

Recent CDMRP Grant Awards

Virginia Commonwealth University, $4 million
Mental Demands of Direct Myoelectric Control in Upper-Limb Prosthesis

University of Washington, $2.6 million
Novel Foot Prosthesis for Amputees with Limited Mobility

University of California at San Francisco, $2 million
Shared Decision-Making in Prosthesis Choice to Improve Patient Outcomes

WillowWood, $1.4 million
Protecting Limb Health Through Optimal Socket Pressure Distribution

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