Organ donation in China: optimism and skepticism on new policies

The American Journal of Transplantation carried this account of China's moves to end its reliance on executed prisoners for transplant organs, in its 24 Sept 2013 issue:

China's transplantation system has undergone a substantial makeover that may end its longstanding reliance on executed prisoners for organ transplants. A new national program for deceased-organ donation based on Chinese cultural and societal norms was announced by Chinese health officials, who say the new system adheres to World Health Organization (WHO) guiding principles and is compliant with the Declaration of Istanbul. Health officials say that with the new program, the use of organs from executed prisoners will be phased out within two years.

The transplant program is based on pilot trials that took place between 2010 and 2012 in 19 of the 31 provincial regions in China, in which organs were obtained from donors after circulatory death.

According to an interview with Haibo Wang, MD, director of the Chinese Organ Transplant Response System Research Center of the Ministry of Health, that appeared in the Bulletin of the World Health Organization in November 2012, “It is not customary—in term of our culture, law and medical practice—to take brain death as the definition of death in China.”[1] For this reason, the new national program will respect Chinese cultural and social values with three categories of donation: 1) organ donation after brain death; 2) organ donation after circulatory death; and 3) organ donation after brain death followed by circulatory death.

The third category “is an important approach that is very unique to China due to its social and cultural perspective regarding death,” says Jiefu Huang, MD, China's former Vice Minister of Health and current head of the Organ Transplant Committee of the National Health and Family Planning Commission (NHF-PC) of the country's Ministry of Health. “The data from the pilot program indicated that China Category in accounted for approaching 50% of overall deceased donors,” says Dr. Huang.

He adds that “another issue is that the final decision making of organ donation rests on family wishes, regardless of the individual's wish before death. This is to respect the Chinese culture, which is very family centered.”

Waitlists, Registries and Allocation

An important aspect of the program is use of a computerized waitlist developed and maintained by the Chinese Organ Transplant Response System based at the University of Hong Kong, which also runs the Chinese Liver Transplant Registry. The kidney registry is based at the 309th Hospital of the People's Liberation Army, the heart registry at The Fuwai Cardiovascular Disease Hospital and the lung registry at Wuxi People's Hospital.

Although the Red Cross Society of China oversaw donation during the pilot trials, there is currently “a battle for the authority to distribute organs,” said Frank Delmonico, MD, president of The Transplantation Society, in a commentary in the July issue of the journalTransplantation.2 He quoted an article published earlier this year in the Journal of Medical Ethics that said the Red Cross would pay families of the deceased for donor organs.[3] Additionally, the Beijing News reported in July that the Red Cross charges hospitals the equivalent of $16,000 US to receive an organ for transplant.[4]

Another option for organ allocation might be one of the registries. Gabriel Danovitch, MD, director of the Kidney and Pancreas Transplant Program at the University of California, Los Angeles, says the international transplant community strongly advocates “the standards of access, transparency, fairness and justice in allocation that is appropriate for a nation as important as China.” He adds, “I sincerely hope that the Chinese Liver Transplant Registry will be given the opportunity to provide access and transparency of allocation for organ transplants within China.”

Jump to…

KEY POINTS

• China says the new program adheres to WHO guidelines and Declaration of Istanbul principles.
• The program includes three categories of donation, and use of a computerized waitlist.
• Transplant professionals have expressed guarded optimism and areas of concern about the new program.

Guarded Optimism or Skepticism?

While Drs. Delmonico and Danovitch have expressed guarded optimism, they note areas of concern. “One is the continued use of donation by execution,” Dr. Danovitch says. “The second is commercialization of organ donation from both deceased- and living-donor sources.” Dr. Delmonico notes that the financial compensation program for deceased-donor organs suggested in the Journal of Medical Ethics article may undermine the trust of families in the determination of death and a societal trust that organs are being distributed fairly.[3]

Three frequent critics of Chinese transplantation say they remain skeptical. Torsten Trey, MD, PhD, co-editor of State Organs: Transplant Abuse in China, and executive director of Doctors Against Forced Organ Harvesting, says that “with the continuous lack of transparency, the new program is as vague as the Chinese Medical Association pledge to the World Medical Association in 2007,” in which China agreed to end organ sourcing from prisoners. Dr. Trey says he's concerned that “prisoners of conscience, in particular unjustly detained Falun Gong practitioners, are forcibly enrolled into the organ donation program. In order to meet international standards, openness to scrutiny is indispensable. Chinese officials often speak of ending China's reliance on prisoners, yet ending reliance—defined (by them) as less than 50%—does not guarantee a complete end.”

David Kilgour, co-author with David Matas of the 2007 report Bloody Harvest: Revised Report into Allegations of Organ Harvesting of Falun Gong Practitioners in China, is also skeptical. He says he doesn't believe China will phase out the use of organs from executed prisoners in the next two years. “The party-state in Beijing knows that governments, legislators, medical professionals and ordinary people across the world are increasingly aware of its inhuman organ pillaging, mainly from Falun Gong prisoners of conscience in forced labor camps, and thus wants to create for the naive the impression that trafficking in organs will soon end,” he says. “All persons of good will wish it would, but it has now gone on since 2001 and still shows no sign of ending.”

Matas says, “I can't predict the future. I'm skeptical for a number of reasons. One is that they are complaining about cultural inhibitions. But this has never been an issue for anything else with the Communists.” He adds, “Will the numbers in the new system ever be sufficient to replace the numbers they are getting from prisoners? It's not clear. I don't think we should take the assurances of the Chinese government that everything is going to be fine and just give us time. I don't think that's an acceptable answer.”

In China, Dr. Huang says “the success of the new deceased organ donation program is the key to end China's reliance on prisoners' organs.” After the pilot trials, “many hospitals decided to abandon the practice of prisoner organ use,” he adds. “The capacity of the new deceased-organ donation is far beyond the prisoner organs and certainly will ease the donor shortage if we can build an effective OPO [organ procurement organization] system in a relatively short time.”

International Forums

A step toward that development took place in May with the First Chinese Organ Procurement Organization International Forum, held in Shenzhen, China. It was announced that the National Italian Transplant Center will help China build and maintain its national organ distribution and safety monitoring system for donors and recipients, as well as provide training on advanced organ donation practices used in the European Union. A five-year cooperative agreement with the Spanish Transplant Procurement Management and Donation and Transplantation Institute will include training programs with Chinese medical staff in China and overseas.

“In May 2014, one year after the kickoff meeting of the new deceased donor program,” Dr. Huang says, “NHFPC is going to host an international conference to create a platform for international and Chinese transplant communities to exchange knowledge from their own experience and, more importantly, work together to review and improve the design of the new deceased-organ donation program.”

Jump to…

References

• 1
  Fleck F. New era for organ donation and transplant in China. Bull WHO November 2012. who.int/bulletin/volumes/90/11/12-031112/en. Accessed September 4, 2013.
• 2
  Delmonico FL. A welcomed new national policy in China. Transplantation 2013; 96: 3–4.

  • Find it @ Stanford
• 3
  Wu X, Fang Q. Financial compensation for deceased organ donation in China. J Med Ethics 2013; 39: 378–379.

  • Find it @ Stanford
• 4
  Agence France-Press. China Red Cross in cash for organ allegations: media, afp.com/en/node/1000950. Updated July 9, 2013. Accessed September 4, 2013.

Surrogacy is big business in India

The BBC has a story: Living inside the house of surrogates

"Commercial surrogacy is estimated to be worth more than $1bn a year in India. While pregnant, some surrogate mothers live in dormitories - which critics call baby factories. They give childless couples the family they have longed for, but what is it like for the women who carry someone else's child for money?"

How dead must a deceased donor be?

How dead do you have to be to be a deceased organ donor, and how dead can you be? Deceased donation of organs for transplantation stretches definitions, because you can't be so very dead that your organs are dead too.

Two recent papers in the New England Journal of Medicine raise this uncomfortable question...

The Dead-Donor Rule and the Future of Organ Donation

Robert D. Truog, M.D., Franklin G. Miller, Ph.D., and Scott D. Halpern, M.D., Ph.D.

N Engl J Med 2013; 369:1287-1289October 3, 2013DOI: 10.1056/NEJMp1307220

The ethics of organ transplantation have been premised on “the dead-donor rule” (DDR), which states that vital organs should be taken only from persons who are dead. Yet it is not obvious why certain living patients, such as those who are near death but on life support, should not be allowed to donate their organs, if doing so would benefit others and be consistent with their own interests.

Life or Death for the Dead-Donor Rule?

James L. Bernat, M.D.

N Engl J Med 2013; 369:1289-1291October 3, 2013DOI: 10.1056/NEJMp1308078

The increasing disproportion between the supply of donor organs and the demand for transplants as well as the tragic deaths of patients awaiting organs have encouraged the development of creative solutions to increase the donor supply. In the domain of donation from deceased donors, the protocols for organ donation after the circulatory determination of death (DCDD) have been one such response. Most U.S. organ-procurement organizations have seen organs from DCDD protocols account for a growing percentage of all organs donated from deceased donors (see graphOrgan Donation in the United States by Donor Status, 2002–2011.). In England, DCDD organs currently constitute a greater percentage than organs donated after the determination of death by brain criteria (“donation after the brain determination of death,” or DBDD).

Another innovative strategy is the kidney-donation protocol recently proposed by Paul Morrissey of Brown University.1 This protocol permits a lawful surrogate decision maker for a patient with a severe, irreversible brain injury (but who is not “brain dead”) to authorize withdrawal of life-sustaining treatment and premortem donation of both kidneys. Whereas DCDD protocols entail removal of organs after the cessation of life-sustaining therapy and the subsequent declaration of death, the Morrissey protocol provides for procuring organs while the patient remains alive. Life-sustaining treatment is withdrawn after the donation has been accomplished. The patient dies of the respiratory complications of the original brain injury, which is fatal in the absence of life-sustaining treatment.

Ads to promote kidney donation in Brazil

Chris Masse alerts me to the interesting site Ads of the World, and points to some of the ads being used to promote kidney donation in Brazil. There's a superhero series that includes Captain America and Spiderman...

Designing the philanthropic ask...

A conference this weekend at Chicago, on Philanthropy, as some market design aspects:

THE SCIENCE OF PHILANTHROPY INITIATIVE (SPI) 
AND 
THE BECKER FRIEDMAN INSTITUTE FOR RESEARCH IN ECONOMICS PRESENT:

The SPI Annual Conference 2013

University of Chicago Booth School of Business

October 18 & 19, 2013

"Putting Research to Work: Together We Can Transform the Way We Ask"

The Warren Center for Network and Data Sciences at Penn

I'm in Philadelphia today, to speak at the inauguration of Penn's new Warren Center for Network and Data Sciences. The directors are Michael Kearns and Ricky Vohra, and they have a multi-disciplinary group of Penn faculty lined up to participate.

Here's the announcement: New Network and Data Sciences Center to Open at Penn

And here's the prospective account of the talk I should try to give...

In addition to Kearns and Vohra, the launch event will feature talks by Eduardo Glandt, the Nemirovsky Family Dean of the School of Engineering and Applied Science, and by Alvin E. Roth of Stanford University, who shared in the 2012 Nobel Prize in Economic Sciences.

Roth’s Nobel-winning work was on a theory for finding mutually beneficial matches between nodes in complex networks. The theory’s applications include the process medical students use to apply for residencies, as well as a program for finding compatible donors and recipients for kidney transplants.    

“We’re planning on funding research projects that, in addition to being scientifically stellar, have some chance of doing social good,” Kearns said. “That’s one of the reasons Roth’s talk is perfect for this launch: network science can show which kidney is compatible with each recipient, and it needs to draw on algorithms, networks and big data sets, but, at the end of the day, this was a research project that saved people’s lives.”

New sources of data for selecting who to hire

Aki Ito has written another story at Bloomberg News about job matching using new kinds of data (the headline is a little misleading though): Machines Gauging Your Star Potential Automate HR Hiring

"A handful of technology companies from Knack.it Corp. to Evolv Inc. are ... developing video games and online questionnaires that measure personality attributes in a job applicant. Based on patterns of how a company’s best performers responded in these assessments, the software estimates a candidate’s suitability to be everything from a warehouse worker to an investment bank analyst.
...
"“People are our biggest resource, and right now a lot of them are mismatched,” said [Erik] Brynjolfsson, who specializes in research on information technology and productivity and is an advisor to Knack. “If you put the right kind of person in the right task, it’s good for that person and it’s good for the company.”
...
"“You have this enormous pool of people that’s being missed because of the way the entire industry goes after the same kinds of people, asking, did you go to Stanford, did you work at this company?” said Erik Juhl, head of talent at Vungle Inc., a San Francisco-based video advertising startup, and formerly a recruiter at Google Inc. and LinkedIn Corp. “You miss what you’re looking for, which is -- what is this person going to bring to the table?”

Veiled surveys to elicit unpopular views

The Atlantic reports on work by some people I know, using a subtly designed survey: Surveys Dramatically Underestimate Homophobia

"Ohio State University Professors Katherine Coffman and Lucas Coffman and Boston University School of Management Professor Keith Marzilli Ericson used a survey research method known as "veiled" reporting to test an array of statements on hot-button issues such as same-sex marriage, homophobic beliefs, and history of same-sex experiences. Unlike traditional anonymous online-survey methods designed to elicit true answers on stigmatized beliefs or practices, this method groups questions so that respondents don't have to answer them directly.

For example, in a normal survey, a person would be asked to answer yes or no about a statement. But in veiled reporting, statements like "I consider myself a heterosexual" are grouped with a bunch of statements like "I remember where I was the day of the Challenger space shuttle disaster," and respondents are asked to say how many statements in the group are true, without having to specify which ones they are saying yes to. A gap between the responses of a control group answering directly and those answering through the veiled-questioning system has been shown to exist for questions where there is a "social desirability bias"—which is to say, where people are inclined to give what they think is the socially acceptable answer."

Pennsylvania Adoption Exchange

Here's a new paper on matching for adoption:

The Pennsylvania Adoption Exchange Improves Its Matching Process
Vincent W. Slaugh, Mustafa Akan, Onur Kesten
Tepper School of Business, Carnegie Mellon University, Pittsburgh, PA 15213
vslaugh@cmu.edu, akan@cmu.edu, okesten@andrew.cmu.edu
M. Utku Unver 
Department of Economics, Boston College, Chestnut Hill, MA, 02467 unver@bc.edu

Abstract: We utilize operations research and market design frameworks to improve the e ectiveness of a recommender system for children in state custody and prospective adoptive families, and describe the implementation of changes to the Pennsylvania Adoption Exchange (PAE). The purpose of PAE is to nd permanent families for hard-to-place children in state custody, and it provides match recommendations to over 200 children each year. After describing PAE's operation, we use data provided by PAE to analyze the relationship between child attributes and adoption outcomes. With the primary objective of improving adoption outcomes, our recommendations cover the information that PAE collects to make recommendations, the decision rules that produce child-family match suggestions, and the interactions between PAE and system participants. We demonstrate the value of improved information about families and children using a discrete-event simulation of PAE. As a result of our collaboration, PAE has begun to collect new information from families and children to better predict match success, to use a spreadsheet tool that provides a more nuanced comparison of family preferences and child attributes, and to change the match recommendation process to reduce strategic manipulation by families. A survey of child case workers in Pennsylvania and interviews with PAE managers guided these changes. Insights from this project are relevant to other adoption exchanges, as well as the placement of children in foster care.
*************************************

A related paper, which I blogged about earlier, is here:
Child-Adoption Matching: Preferences for Gender and Race, 2013, by  Mariagiovanna Baccara, Allan Collard-Wexler, and Leonardo Felli, and Leeat Yariv, American Economic Journal: Applied Economics, forthcoming. 

Nobel to Fama, Hansen, and Shiller

Hearty congratulations to Gene Fama, Lars Peter Hansen, and Robert Shiller, who won the Economics Nobel today for Trendspotting in Asset Markets (for changing our understanding of asset prices)  I predict that they will have an exciting and busy year.

Others will write more expertly than I about their work on asset prices, and about finance and behavioral finance. And journalists will be glad to have economics laureates who do something that journalists and the public think that economists do (in contrast to last year's laureates who did something further from the popular conception of economics).

Let me just add a handclap or two by pointing out that Shiller is also a market designer: I've always admired his 1993 Clarendon lectures, Macro Markets: Creating Institutions for Managing Society's Largest Economic Risks. (Here's my brief 2009 post on that...)

Nobel labs: panoramic photos

One of the funnier post-Nobel phenomena, aside from the attention of journalists, is the attention of artists.  The most interesting of those whom I have interacted with is photographer Volker Steger, who in collaboration with the Landau organization has created a series of photo/interviews consisting of panoramic portraits of the places where Laureates work, together with links to embedded interviews, some just audio, and some video: NOBEL LABS 360° An Interactive Multimedia Project.

You can see the interviews/photos taken so far here: NOBEL LABS 360°, and here are the interviews with me at Stanford. including some in our actual lab, and with my colleague Muriel Niederle.

I haven't fully figured out how to navigate the site, but you can let the panorama rotate slowly, or you can navigate to parts of it by experimenting with your mouse...if you click on the link called "Introducing Alvin Roth" you can see a video of me working at and walking on (and talking about) my treadmill desk...and if you explore more you can find a nice shot that includes Rodin's Burghers of Callais on the Stanford campus.

Tomorrow I will graduate from being the most recent Economics laureate to a more emeritus status, and I'm looking forward to a few fewer distractions, although some of them have been quite fun.

EU debate: who gets the maternity leave in a surrogate birth?

The WSJ has the story: Surrogate Births Stir Divisions in EU--Long Contentious, The Practice is Now Splitting Europe's top court

"EU laws entitle women in the 28-country bloc to at least 14 weeks of paid maternity leave, although many states offer longer leave than that.

"The laws on surrogacy, by contrast, are much less harmonized. Eight EU member states, among them Germany, France, Italy and Spain, prohibit women from carrying another woman's child altogether. Those nations say they fear the practice could lead to the exploitation of women in financial difficulty or create emotional problems for surrogate mothers who give up the child they carried to birth.

"Other European states prohibit payments that go beyond compensation for medical expenses or restrict the use of fertility treatments or egg donation in surrogacy arrangements.

"In the U.S., laws on surrogacy also vary from state to state, with some placing limits on how much money surrogate mothers can be paid. Since there's no federal right to paid maternity leave, it's generally up to employers to design their own policies. The federal Family Medical Leave Act allows workers—men and women—to take up to 12 weeks of unpaid leave to take care of a relative, provided the company they work for has at least 50 employees.

"Despite the limitations, surrogacy is becoming increasingly popular in Europe. Many childless couples look to other countries, such as Ukraine, India or the U.S.— to find surrogate mothers."

Horses and slaughterhouses

Controversy about whether there should be horse slaughterhouses in the United States has made the news because of controversy between American Indian groups whose treaty lands are overrun by feral horses, and horse protection organizations that include actors who have played American Indian roles in films: On Fate of Wild Horses, Stars and Indians Spar

"Free-roaming horses cost the Navajos $200,000 a year in damage to property and range, said Ben Shelly, the Navajo president. There is a gap between reality and romance when, he said, “outsiders” like Mr. Redford — who counts gunslinger, sheriff’s deputy and horse whisperer among his movie roles — interpret the struggles of American Indians.
...
"The horses, tens of thousands of them, are at the center of a passionate, politicized dispute playing out in court, in Congress and even within tribes across the West about whether federal authorities should sanction their slaughtering to thin the herds. The practice has never been banned, but stopped when money for inspections was cut from the federal budget.

"In Navajo territory, parched by years of unrelenting drought and beset by poverty, one feral horse consumes 5 gallons of water and 18 pounds of forage a day — sometimes the water and food a family had bought for itself and its cattle.

"According to the latest estimates, there are 75,000 feral and wild horses in the nation, and the numbers are growing, Mr. Shelly said. They have no owners, and many of them are believed to be native to the West. The tribes say they must find an efficient way of reducing the population. Although it is common to shoot old and frail horses — and more merciful than a ride to the slaughterhouse — there are too many of them to be dealt with, and there is some money in rounding them up and selling them at auction.
...
"The United States has never fostered a market for horse meat, a dietary staple in places like Belgium, China and Kazakhstan. It does have a history of horse slaughtering, though; at one point, there were more than 10 such slaughterhouses in the country. The last three, one in Illinois and two in Texas, closed in 2007, after Congress banned the use of federal money for salaries for personnel whose job was to inspect the horses and the facilities where they would be slaughtered. (One thing inspectors look for is evidence of drug use on the horses, not uncommon among those once used for racing.)

"In their last year, the three plants slaughtered a total of 30,000 horses for human consumption and shipped an additional 78,000 for slaughter in Canada and Mexico, according to statistics by United States and Canadian authorities. Congress’s subsequent unwillingness to finance inspections made slaughtered horse meat ineligible for the seal of inspection it needs to be commercially sold, effectively ending the practice.

"Wayne Pacelle, the president of the Humane Society of the United States, a lead plaintiff in the lawsuit and one of the groups lobbying Congress to end horse slaughter, said its efforts were focused on preventing the killing of horses for human consumption “to avoid creating an industry that would turn horses into a global food commodity.”

Online anonymity, bitcoin, illegal drug markets, and traditional law enforcement

If you were a Silk Road customer, you'll have to find another online drug market: F.B.I. Seizes Silk Road, an Online Drug Market, and Makes Arrest. But it sounds like while the organizer was arrested (after soliciting a murder for hire) the anonymity of transactions may have allowed many of the customers to escape detection.

"The Silk Road marketplace is available through Tor, a popular tool for maintaining anonymity online. Bitcoin, a virtual currency, is used for transactions. The identities of sellers are not known to the buyers. About $1.2 million in sales were conducted a month in early 2012, according to a study by an assistant professor at Carnegie Mellon University, Nicolas Christin.

"As part of the investigation into Silk Road, authorities said, they seized 26,000 bitcoins worth $3.6 million.

"The arrest is part of the latest push by federal authorities to police the anonymous marketplaces that have flourished as a result of virtual currencies and software meant to help users browse the Web anonymously. In recent months, federal authorities charged seven people believed to be linked to Liberty Reserve, another virtual currency, which prosecutors described as a $6 billion money-laundering operation that facilitated a black market for everything from stolen identities to child pornography.

"One recent study found that a broad range of drugs, including ecstasy, LSD and heroin, were available on Silk Road, but that marijuana was the most popular item offered for sale. Books and erotica are also sold.

The Algorithm of Happiness...

Elliott Peranson sends me the following note:

The NRMP has redone their web site at www.nrmp.org. Check out their new tagline on the home page. Sounds more appealing than the "Roth-Peranson Algorithm". 

Saving babies with no questions asked

Sign at a Cambridge, MA fire station, September 2013

Recent NBER papers bearing on market design

Here are three:

The Effects of Mandatory Transparency in Financial Market Design: Evidence from the Corporate Bond Market

Paul Asquith, Thom Covert, Parag Pathak

NBER Working Paper No. 19417
Issued in September 2013
NBER Program(s):   AP   CF 

Many financial markets have recently become subject to new regulations requiring transparency. This paper studies how mandatory transparency affects trading in the corporate bond market. In July 2002, TRACE began requiring the public dissemination of post-trade price and volume information for corporate bonds. Dissemination took place in Phases, with actively traded, investment grade bonds becoming transparent before thinly traded, high-yield bonds. Using new data and a differences-in-differences research design, we find that transparency causes a significant decrease in price dispersion for all bonds and a significant decrease in trading activity for some categories of bonds. The largest decrease in daily price standard deviation, 24.7%, and the largest decrease in trading activity, 41.3%, occurs for bonds in the final Phase, which consisted primarily of high-yield bonds. These results indicate that mandated transparency may help some investors and dealers through a decline in price dispersion, while harming others through a reduction in trading activity.

The Impact of the Internet on Advertising Markets for News Media

Susan Athey, Emilio Calvano, Joshua Gans

NBER Working Paper No. 19419
Issued in September 2013
NBER Program(s):   IO   PR 

In this paper, we explore the hypothesis that an important force behind the collapse in advertising revenue experienced by newspapers over the past decade is the greater consumer switching facilitated by online consumption of news. We introduce a model of the market for advertising on news media outlets whereby news outlets are modeled as competing two-sided platforms bringing together heterogeneous, partially multi-homing consumers with advertisers with heterogeneous valuations for reaching consumers. A key feature of our model is that the multi-homing behavior of the advertisers is determined endogenously. The presence of switching consumers means that, in the absence of perfect technologies for tracking the ads seen by consumers, advertisers purchase wasted impressions: they reach the same consumer too many times. This has subtle effects on the equilibrium outcomes in the advertising market. One consequence is that multi-homing on the part of advertisers is heterogeneous: high-value advertisers multi-home, while low- value advertisers single-home. We characterize the impact of greater consumer switching on outlet profits as well as the impact of technologies that track consumers both within and across outlets on those profits. Somewhat surprisingly, superior tracking technologies may not always increase outlet profits, even when they increase efficiency. In extensions to the baseline model, we show that when outlets that show few or ineffective ads (e.g. blogs) attract readers from traditional outlets, the losses are at least partially offset by an increase in ad prices. Introducing a paywall does not just diminish readership, but it furthermore reduce advertising prices (and leads to increases in advertising prices on competing outlets).

Privacy and Data-Based Research

Ori Heffetz, Katrina Ligett

NBER Working Paper No. 19433
Issued in September 2013
NBER Program(s):   AG   LS   PE 

What can we, as users of microdata, formally guarantee to the individuals (or firms) in our dataset, regarding their privacy? We retell a few stories, well-known in data-privacy circles, of failed anonymization attempts in publicly released datasets. We then provide a mostly informal introduction to several ideas from the literature on differential privacy, an active literature in computer science that studies formal approaches to preserving the privacy of individuals in statistical databases. We apply some of its insights to situations routinely faced by applied economists, emphasizing big-data contexts.

Matching couples, in the QJE

Our paper on couples has appeared online at the QJE: MATCHING WITH COUPLES: STABILITY AND INCENTIVES IN LARGE MARKETS

Here are the links on Parag Pathak's page, including the links to the original working paper which has some material absent from the published version.

Kojima, Fuhito, Parag A. Pathak, and Alvin E. Roth, 
Matching with Couples: Stability and Incentives in Large Markets 
(Appendix, Computer Programs, older version NBER 16028 with statement and proof of Thm 2)

Quarterly Journal of Economics, 2013, 128(4)


I blogged about it earlier here.

Here's the abstract:

Accommodating couples has been a long-standing issue in the design of centralized labor market clearinghouses for doctors and psychologists, because couples view pairs of jobs as complements. A stable matching may not exist when couples are present. This article’s main result is that a stable matching exists when there are relatively few couples and preference lists are sufficiently
short relative to market size. We also discuss incentives in markets with couples. We relate these theoretical results to the job market for psychologists, in which stable matchings exist for all years of the data, despite the presence of couples. 

Jeff Ely thinks deeply about dating mechanisms, and beliefs

The convention in 'speed dating' is that everyone is asked who they would like to meet again, and only if you and someone else both indicate each other are you given one another's contact information so that you can arrange a date.  This has a lot of good features, but it does mean that if you indicate you would like to go on a date with someone and you don't get their contact info, you learn that they didn't want to go on a date with you (which you might have preferred not to know).

Here's Jeff over at Cheap Talk, thinking about alternative mechanisms before settling on the familiar one:

First you are asked whether you would like to hook up with your friend. Then you are asked whether you believe your friend would like to hook up with you. These are just setup questions. Now come the important ones. Assuming your friend would like to hook up with you, would you like to know that? Assuming your friend is not interested, would you like to know that? And would you like your friend to know that you know?

Assuming your friend is interested, would you like your friend to know whether you are interested? Assuming your friend is not interested, same question. And the higher-order question as well.

These questions are eliciting your preferences over you and your friend’s beliefs about (beliefs about…) you and your friend’s preferences. This is one context where the value of information is not just instrumental (i.e. it helps you make better decisions) but truly intrinsic. For example I would guess that for most people, if they are interested and they know that the other is not that they would strictly prefer that the other not know that they are interested. Because that would be embarrassing.

And I bet that if you are not interested and you know that the other is interested you would not like the other to know that you know that she is interested. Because that would be awkward.

Notice in fact that there is often a strict preference for less information. And that’s what makes the design of a matching mechanism complicated.  Because in order to find matches (i.e. discover and reveal mutual interest) you must commit to reveal the good news. In other words, if you and your friend both inform the experimenters that you are interested and that you want the other to know that, then in order to capitalize on the opportunity the information must be revealed.

But any mechanism which reveals the good news unavoidably reveals some bad news precisely when the good news is not forthcoming. If you are interested and you want to know when she is interested and you expect that whenever she is indeed interested you will get your wish, then when you don’t get your wish you find out that she is not interested.

Fortunately though there is a way to minimize the embarrassment. The following simple mechanism does pretty well. Both friends tell the mediator whether they are interested.  If, and only if, both are interested the mediator informs both that there is a mutual interest. Now when you get the bad news you know that she has learned nothing about your interest. So you are not embarrassed.

However it doesn’t completely get rid of the awkwardness. When she is not interested she knows that *if* you are interested you have learned that she is not interested. Now she doesn’t know that this state of affairs has occurred for sure. She thinks it has occurred if and only if you are interested so she thinks it has occurred with some moderate probability. So it is moderately awkward. And indeed you know that she is not interested and therefore feels moderately awkward.

The theoretical questions are these:  under what specification of preferences over higher-order beliefs over preferences is the above mechanism optimal? Is there some natural specification of those preferences in which some other mechanism does better?

Update: Ran Spiegler points me to this related paper.

The Handbook of Market Design

The Handbook of Market Design, from Oxford University Press, is out (it's been printed), and should be available by the time you read this.

Here's the Table of Contents:

You could place your order here:)

Course allocation at U. Toronto

U of T students trade cash for seats in full classes

University of Toronto students are buying and selling spots in fully-booked courses, turning registration into a bidding war.

“$100 to whomever drops (History of Modern Espionage),” posted Christopher Grossi on Facebook Tuesday. “I really need this course.”

The third-year history student said the 180-person course filled up before his designated registration time. After talking to the professor without success, he said offering money was his last chance to coax someone to trade with him.

The university’s course registration system prioritizes students based on need and creates a wait list for full classes, said Glenn Loney, assistant dean and faculty registrar of the university’s Faculty of Arts and Science.

But there is a narrow window of opportunity in the days after the wait list closes and before the final deadline for students to add or drop courses.

“Once the university drops the wait list, it’s mostly just every man for themselves,” Grossi said.

Some students have taken to Facebook to name a price for their coveted seat. In a post earlier this week, one student offered to sell her spots in two psychology courses for $50 apiece — or she’ll swap for a space in another psychology class.

Third-year computer science student “Lee,” who would not give his full name for fear of repercussions by the university, said he has sold his spot in courses twice, for $20 each. After arranging the deal through the university’s internal email system, Lee met the buyer in the library. On the university’s registration website, Lee dropped the course and the buyer applied for it immediately afterward, snagging Lee’s newly vacated spot.

Loney said students have been swapping spots in courses for years and there are no rules against it.

“There’s nothing that would put it in the same league as cheating, or an academic advantage,” he said, adding there is a limit to the number of courses a student can enrol in to prevent someone from stocking up on courses with the intent to sell.

Where arrangements were once made through friends, social media has created a much larger marketplace to connect desperate buyers with enterprising sellers.

“Most students find it reprehensible, and don’t participate in it at all,” Loney said. “There’s usually a torrent of abuse heaped on the people who are trying to sell.”

New Orleans School Choice in the WSJ

 School choice in New Orleans is the subject of this WSJ story, which focuses on the search for good school places, and how choice helps...

Inside the Nation's Biggest Experiment in School Choice

"Denver, Chicago and Cleveland have embraced school choice on a smaller scale, but none give as much freedom—to parents and campuses—as New Orleans does: About 84% of its 42,000 public school students attend charters, the largest share of any district in the U.S."

Unravelling in the Business School job market

The WSJ has a video report

Here's the caption: 

Top B-School Talent Plucked Before Class Starts

Schools try to restrict when companies can start coming to campus. But that doesn’t limit what companies try to do off-campus, and it’s not uncommon for students to show up at orientation with internship offers for next summer in hand.

HT: Jon Levin

MOOCS: massive online certifiers

There's an increasing move among companies that offer MOOCs, Massive Online Courses, to also offer certification.  This may be where the money is.

e.g. this from the WSJ: Job Market Embraces Massive Online Courses--Seeking Better-Trained Workers, AT&T, Google and Other Firms Help Design and Even Fund Web-Based College Classes

""The common denominator [among the new MOOC certification programs] is that there really is an interest in finding credentials that don't require a student to buy the entire degree," said Sebastian Thrun, the Stanford University computer-science professor who co-founded Udacity, a MOOC with 1.6 million enrolled students in 200 countries. "This is really democratizing education at its best."

Organ donation registration on college applications, in India

Here's the story: Governor tells V-Cs to offer option for organ donation in college admission forms

"In a meeting held recently, the governor had urged the V-Cs to offer a separate column in the college admission forms for organ donation. T C Benjamin, Additional Chief Secretary (public health) said filling the column is not mandatory and students will have the choice. The state had made it a must for hospitals to inform the organ transplant centres about brain-dead patients. "

Further unraveling of (combined) college and medical school admissions

Shenendehowa to offer early medical school acceptance

"CLIFTON PARK — A new program that may be the first of its kind in the nation will allow one medicine-minded Shenendehowa High School student to get accepted to college and medical school early — a few months before the junior prom.

"More than a year before classmates know where they’re going after graduation, one student who undergoes a rigorous application process will be accepted into Siena College’s and Albany Medical College’s combined eight-year physician program. On Thursday, officials from the school district and both colleges announced the program — “ShenNext Medicine: Selecting Tomorrow’s Doctors Today.”

"They believe the program is the first in the country to admit a student as a junior, though many institutions have partnerships that accept high school seniors to undergraduate colleges and medical schools at the same time. Siena and Albany Medical College have had such a partnership for 27 years, and Albany Med has similar programs with Union College and Rensselaer Polytechnic Institute.

"Juniors in the Shen program still have to complete their senior year and maintain good grades."

HT: Mary O'Keeffe

Study mechanism design online with Jason Hartline

Jason Hartline writes:

Please share the following announcement:

   *** Online Self-study on Mechanism Design and Approximation  ***

   Web: http://www.eecs.northwestern.edu/hartline/courses/mdna.html

   Discussion: https://piazza.com/northwestern/fall2013/eecs499/home

   To enroll: go to course page on Piazza and enroll as a student.

Synopsis. This course is a self-study course based on the manuscript "Mechanism Design and Approximation" which is based on a graduate course that has been developed at Northwestern over the past five years. Over the fall quarter we will work through roughly one chapter per week. The week will start with students reading and discussing the material of the chapter and it will conclude with students working together to solve and write up solutions to the chapter exercises.  The textbook is in final draft and your comments and suggestions will help improve the book for future students.

Excerpt from Chapter 1: Our world is an interconnected collection of economic and computational systems. Within such a system, individuals optimize their actions to achieve their own, perhaps selfish, goals; and the system combines these actions with its basic laws to produce an outcome. Some of these systems perform well, e.g., the national residency matching program which assigns medical students to residency programs in hospitals, e.g., auctions for online advertising on Internet search engines; and some of these systems perform poorly, e.g., financial markets during the 2008 meltdown, e.g., gridlocked transportation networks. The success and failure of these systems depends on the basic laws governing the system. Financial regulation can prevent disastrous market meltdowns, congestion protocols can prevent gridlock in transportation networks, and market and auction design can lead to mechanisms for allocating and exchanging goods or services that yield higher profits or increased value to society.

This text focuses on a combined computational and economic theory for the study and design of mechanisms. A central theme will be the tradeoff between optimality and other desirable properties such as simplicity, robustness, computational tractability, and practicality. This tradeoff will be quantified by a theory of approximation which measures the loss of performance of a simple, robust, and practical approximation mechanism in comparison to the complicated and delicate optimal mechanism. The theory provided does not necessarily suggest mechanisms that should be deployed in practice, instead, it pinpoints salient features of good mechanisms that should be a starting point for the practitioner.

Market Design conference(s) in June at Stanford

Scott Page sends the following email announcement:

Dear All,

I have exciting news about the 2014 NSF/CEME Decentralization Conference.

- It will take place on June 8-9, 2014 in Palo Alto, California.

- Fuhito Kojimo of Stanford University will be the local organizer.

- The conference will be collocated with two other major mechanism design conferences: the NBER Market Design Conference and the ACM Conference on Economics and Computation.  The conferences will run sequentially with overlapping plenary sessions, with the Decentralization Conference running for the first two days, followed by the Market Design Conference and then ACM.

- Participants are encouraged to attend all three conferences and to bring graduates students.

-  We will be sending out an official call for papers in about a month.

I think this will be an incredible opportunity to bring together three communities that look at similar questions and use similar tools.  I recognize that the June date is later than our typical March or April meeting, and apologize for any inconvenience this might cause.  

Here is the “official” announcement from Susan Athey, David Parkes and myself.  Please feel free to forward this email to anyone who might be interested.

         ACM, Market Design and Decentralization Conference

                                    June 8 -12, 2014

  Palo Alto, CA

The ACM Conference on Economics and Computation (EC'14), the NBER Market Design Conference, and the NSF/CEME Decentralization Conference will collocate this June at Stanford University.  The jointly run conferences will include both joint and independent sessions to facilitate greater interactions across the three research communities.  The joint sessions will include invited keynote presentations by leaders in the fields of incentives, market design, computation, and decentralization. Proposals for presentations in the independent sessions should be submitted following the procedures of each individual conference.  Individuals who normally participate in one of the conferences are strongly encouraged to also attend the other conferences so as to build a more interdisciplinary community of scholars interested in common topics.

Why it's hard to get hot restaurant reservations or concert tickets (and why concierges sometimes can)

It turns out you need professional gear to get some reservations: the New Statesman has a report from the front.

The Bot Wars: why you can never buy concert tickets online

Enterprising programmers are creating bots that can reserve, and in some cases buy, everything from restaurant tables to eBay goods before humans can even get a look in. Where will the bot wars end?

"Just as high frequency trading, via automated software, took over the financial markets in the early 2000s, the use of bots is a technique that is increasingly coming to dominate online sales of all stripes."
*********
Some of my earlier posts on this subject here,  here and here  focused on concert tickets and professional re-sellers (scalpers) who sometimes skirt the law.


HT: Dean Jens