Based on a preponderance of the evidence, the institution’s deciding official usually makes the final determination whether to accept the investigation report, its findings, and the recommended institutional actions. If this determination varies from that of the investigation committee, the deciding official needs to explain in detail the basis for rendering a decision different from that of the investigation committee in the institution's letter transmitting the report to ORI. The explanation should be consistent with the PHS definition of research misconduct, the institution's policies and procedures, and the evidence reviewed and analyzed by the investigation committee. The deciding official may also return the report to the investigation committee with a request for further fact-finding or analysis. The deciding official's determination, together with the investigation committee's report, constitutes the final investigation report for purposes of ORI review.

When a final decision on the case has been reached, the institution should notify the respondent  in writing. In addition, the deciding official will determine whether law enforcement agencies, professional societies, professional licensing boards, editors of journals in which falsified reports may have been published, collaborators of the respondent in the work, or other relevant parties should be notified of the outcome of the case. The institution is also responsible for ensuring compliance with all notification requirements of funding or sponsoring agencies.

In addition, the institutional policy may permit an appeal. If so, the policy should specify the grounds for an appeal and the procedures for filing an appeal.