An experiment on the impact of predictive analytics on kidney offers acceptance decisions

被引:8
作者
McCulloh, Ian [1 ,2 ]
Stewart, Darren [3 ]
Kiernan, Kevin [1 ]
Yazicioglu, Ferben [1 ]
Patsolic, Heather [1 ]
Zinner, Christopher [1 ]
Mohan, Sumit [4 ,5 ]
Cartwright, Laura [3 ]
机构
[1] Accenture, Discovery Lab, Appl Intelligence, Washington, DC USA
[2] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD 21218 USA
[3] United Network Organ Sharing, Richmond, VA USA
[4] Columbia Univ, Vagelos Coll Phys & Surg, Dept Med, New York, NY USA
[5] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA
关键词
clinical decision making; organ procurement; transplantation network; time-to-next offer; kidney; UNOS; DECEASED DONOR KIDNEYS; DISCARD RATES; RISK; TRANSPLANTATION; PROCUREMENT; EQUITY;
D O I
10.1016/j.ajt.2023.03.010
中图分类号
R61 [外科手术学];
学科分类号
摘要
Because of the breadth of factors that might affect kidney transplant decisions to accept an organ or wait for another, presumably "better" offer, a high degree of heterogeneity in decision making exists among transplant surgeons and hospitals. These decisions do not typically include objective predictions regarding the future availability of equivalent or betterquality organs or the likelihood of patient death while waiting for another organ. To investigate the impact of displaying such predictions on organ donation decision making, we conducted a statistically designed experiment involving 53 kidney transplant professionals, in which kidney offers were presented via an online application and systematically altered to observe the effects on decision making. We found that providing predictive analytics for time-to-better offers and patient mortality improved decision consensus and decision-maker confidence in their decisions. Providing a visual display of the patient's mortality slope under accept/reject conditions shortened the time-to-decide but did not have an impact on the decision itself. Presenting the risk of death in a loss frame as opposed to a gain frame improved decision consensus and decision confidence. Patient-specific predictions surrounding future organ offers and mortality may improve decision quality, confidence, and expediency while improving organ utilization and patient outcomes.
引用
收藏
页码:957 / 965
页数:9
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