Estimating the Patient's Price of Privacy in Liver Transplantation

DATE: April 14, 2009

TIME: 11:00 AM – 12:00 PM

LOCATION: Executive classroom

FEES: none

EVENT CONTACT:

Jennifer Harris, ISyE
Contact Jennifer Harris
404-894-2300

TITLE: Estimating the Patient's Price of Privacy in Liver Transplantation

SPEAKER: Dr. Andrew Schaefer

ABSTRACT:

Patients with end-stage liver disease, such as hepatitis or cirrhosis, must join a waiting list to be eligible for a cadaveric liver. Due to privacy concerns, the composition of this waiting list is not publicly available. We consider the benefit of creating a more transparent waiting list, which we term the patient's price of privacy. We estimate this benefit by modeling the liver accept/reject decision under a transparent waiting list as a Markov decision process in which the state includes an explicit measure of the patient's rank in the waiting list. We provide conditions under which there exist structured optimal solutions, such as monotone value functions and control-limit policies. We conduct numerical studies based on clinical data, which indicate that the price of privacy is typically on the order of 5% of the optimal expected survival. Finally, we describe a liver accept/reject model in which the patient's position on the waiting list is partially observed. Our numerical studies indicate that solving the resulting partially observed Markov decision process eliminates the price of privacy.