How we balance efficieny and equity in liver transplantation

1. Policy Selection for Balancing Efficiency and Equity in US Liver Transplantation - An AHP Approach Thesis Proposal Vijay M. Veerachandran [email_address] Dr.Nan Kong, Chair Committee members: Dr. José Zayas-Castro Dr. Kingsley Reeves Department of Industrial and Management Systems Engineering College of Engineering University of South Florida

6. Current Allocation Model

20. Hierarchy CRITERIA ALTERNATIVES GOAL

21. Step 2 - Comparison scale 9 Extremely Preferable,Important or Likely 8 7 Very strongly Preferable,Important or Likely 6 5 Strongly Preferable,Important or Likely 4 3 Moderately Preferable,Important or Likely 2 1 Equally Preferable,Important or Likely

22. Pairwise Comparison among Evaluation Criteria 0.2129 1 0.166667 7 0.3333 Seediness 0.4371 6 1 8 1 Appearance 0.1851 0.142857 0.125 1 7 Quality 0.1647 3 1 0.1428 1 Color Weights Seediness Appearance Quality Color CRITERION

23. Pairwise Comparison of Color among Alternatives 0.692308 1 9.00001 3 Grapes 0.076923 0.111111 1 0.333333 Orange 0.230769 0.333333 3 1 Apple Weights Grapes Orange Apple ALTERNATIVE

25. Global Evaluation 0.178178 0.737498 0.142857 0.692308 Grapes 0.751405 0.0852256 0.714286 0.076923 Orange 0.0704176 0.177276 0.142857 0.230769 Apple 0.212907 0.437111 0.185184 0.164798 Weights Seediness Appearance Quality Color Evaluation

26. Results 0.50084 0.037935 0.3223684 0.0264 0.114090 Grapes 0.34218 0.159979 0.037253 0.1322 0.012676 Orange 0.15696 0.014992 0.0774892 0.0264 0.038030 Apple Results Seediness Appearance Quality Color SUM PRODUCT

27. Fruit Selection

28. Literature Review - AHP Themes

29. Literature Review – AHP Application Areas

31. Model: Transplantation Outcomes ALLOCATION TYPE- LOCAL/REGIONAL/NATIONAL/FOREIGN 12 RECIPIENT DAYS BETWEEN PREVIOUS AND CURRENT TRANSPLANT 11 RECIPIENT LENGTH OF STAY FROM TRANSPLANT TO DISCHARGE 10 AGE IN YEARS AT TIME OF LISTING 9 MELD SCORE 8 DAYS ON LIVER WAITING LIST 7 COLD ISCHEMIC TIME (HOURS) 6 RECIPIENT DIED (1=DEAD,0=ALIVE) 5 STATE OF RESIDENCY @ REGISTRATION RECIPIENT LENGTH OF STAY POST TX 4 GENDER AGE IN YEARS AT TIME OF LISTING 3 ETHNICITY CATEGORY THE NUMBER OF PREVIOUS TRANSPLANTS 2 RACE AVERAGE COLD ISCHEMIC TIME (HOURS) 1 Equity Efficiency No

32. Hierarchy Selection of best Policy Efficiency Equity Average MELD score No: Patients waiting list Average Waiting time Race Geography Asian Hispanic Afro-American Difference in Meld Score Difference in waiting time Gender Policy A Policy B Policy x

36. Simulated allocation Modeling

38. Thanks !!!

39. Questions ?

42. Current Liver Allocation Policy

43. Literature Review - AHP Themes