Reporting and misreporting from Organ Procurement Organizations (OPOs)

 Because there are shortages of organs for transplant, it is important to measure how successful Organ Procurement Organizations (OPOs) are at recovering and transplanting organs.  But sometimes definitions can get in the way, and this was the case in islet transplants from deceased donors, into patients with diabetes.  Pancreatic islets are the cells that produce insulin, and it was (and I think still is) regarded as an experimental procedure to transplant islets from a deceased donor's pancreas, rather than the whole pancreas.  So islet transplantation was classified as a research activity.

To encourage this use of deceased donor pancreases, recovery of a pancreas "for research" was counted as a transplant. But some OPO's have heavily gamed this, reporting that they recovered a pancreas when the "research" wasn't connected to transplantation.  That loophole is now being closed.

Here's a January 18 memo from HHS, CMS, Center for Clinical Standards and Quality

Organ Procurement Organization (OPO) Conditions for Coverage – Definition Clarification 

"Background:

"The OPO CfCs are intended to drive improvements in organ procurement and transplantation through, among other provisions, the donor and transplantation outcome measures. OPOs are required to report data related to pancreata procured for research, and this data is incorporated into calculations used to assess compliance with the donor and transplant outcome measures and are used for re-certification purposes. To facilitate accurate reporting of data related to pancreata donors, the term “donor” is defined in CMS regulation to specify that, among other requirements, an individual would be considered a donor even if only the pancreas is procured and is used for research or islet cell transplantation.

"CMS has noted a significant increase in the number of pancreata procured since this definitionwas revised in 2020, raising questions about the interpretation of this definition by OPOs and how this definition is applied to reporting data related to donors of pancreata used for islet cell research. There is a concern that the increase in pancreata procured may not reflect a meaningful increase in pancreata being actually used for islet cell research, and instead may reflect pancreata procured for other purposes. This memo is clarifying that the pancreata must be used for islet cell research. 

...

"In summary, this memo is clarifying that consistent with the Pancreatic Islet Cell Transplantation Act of 2004, only pancreata procured by an OPO and used for islet cell transplantation or research shall be counted"

Legislative proposals to help living kidney donors

 Martha Gershun brings us up to date on various proposed pieces of legislation to help organ donors and increase access to transplants.

Legislative Efforts to Support Living Kidney Donors,  by Martha Gershun, Guest Blogger

"As a member of the Expert Advisory Panel to the Kidney Transplant Collaborative, I have been honored to provide input during the development of the organization’s priority legislation, the Living Organ Volunteer Engagement (LOVE) Act.  This legislation would help build a comprehensive national living organ donor infrastructure that would support a national donor education program, create a donor navigator system, ensure appropriate donor cost reimbursement, collect essential data, and improve all aspects of living organ donation across the country, substantially reducing barriers that limit participation today.

Key provisions of the LOVE Act would:

• Provide reimbursement for all direct and indirect costs for living donation, including lost wages up to $2,500 per week.
• Provide life and disability insurance for any necessary care directly caused by donation.
• Modify NLDAC rules so neither the recipient’s income nor the donor’s income would be considered for eligibility.
• Provide for new public education program on the importance and safety of living organ donation.
• Provide for new mechanisms to collect and analyze data about living organ donation to enable evidence-based continuous process improvement.

Numerous other federal proposals are also currently vying for support to address barriers to living donation on a national level.  They include:

Living Donor Protection Act (H.R. 2923, S. 1384)

• Prohibits insurance carriers from denying, canceling, or imposing conditions on policies for life insurance, disability insurance, or long-term care insurance based on an individual’s status as a living organ donor.
• Specifies that recovery from organ donation surgery constitutes a serious health condition that entitles eligible employees to job-protected medical leave under the Family and Medical Leave Act.

Organ Donor Clarification Act (H.R. 4343)

• Clarifies that reimbursement to living organ donation is not “valuable consideration” (I.e., payment), which is prohibited under the National Organ Transplant Act (NOTA)
• Allows pilot programs to test non-cash compensation to living organ donors.
• Modifies NLDAC rules so the recipient’s income would no longer be considered for eligibility.

Living Organ Donor Tax Credit Act (H.R. 6171)

• Provides a $5,000 federal refundable tax credit to offset living donor expenses.

Honor Our Living Donor (HOLD) Act (H.R. 6020)

• Modifies NLDAC rules so the recipient’s income would no longer be considered for eligibility.
• Requires public release of annual NLDAC report.

Helping End the Renal Organ Shortage (HEROS) Act

• Provides a $50,000 refundable federal tax credit over a period of five years for non-directed living kidney donors.

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And here's one more, from the Coalition to Modify NOTA

AEA's lockbox: recording allegations while reserving the right to report them

The American Economic Association has announced that they have initiated a Reporting Lockbox – Now Available to Members, meant to allow members to record transgressions such as sexual harassment while reserving and preserving the right to report them later, if the same individual is named as an offender by someone else. The idea is to allow repeat offenders to be identified, even if each offense might be too ambiguous to justify an immediate complaint.

"The Reporting Lockbox enables AEA members who are not yet ready to file a formal complaint to log circumstances or conduct by other members that may violate the AEA’s policy against harassment, discrimination, and retaliation. If two or more AEA members log alleged incidents of harassment, discrimination, or retaliation perpetrated by the same person by making entries in this digital archive and indicating a willingness to communicate with other alleged victims, each member who logged an incident will be contacted separately to determine if each would consider communicating with the other members, or to otherwise keep the submission active or withdraw it. A mutual decision to contact the other members who logged an incident about the same alleged perpetrator could lead to their filing a formal complaint with the AEA Ethics Committee or pursuing other options outside of the AEA.

"The AEA will not have access to the Reporting Lockbox, and therefore will not know the identities of members or persons of interest unless action is taken by the members through the filing of a formal complaint to the AEA. Users of the Lockbox can edit or remove entries at any time."
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Earlier related post:

Wednesday, November 1, 2017

Callisto: Designing a reporting system for sexual assault

Incentives and mis-incentives in science (Freakonomics part II)

 Freakonomics has a second post on fraud in science, and you can listen or read the transcript here:

Can Academic Fraud Be Stopped?

Two quotes stood out for me:

1. VAZIRE: Oh, I don’t mind being wrong. I think journals should publish things that turn out to be wrong. It would be a bad thing to approach journal editing by saying we’re only going to publish true things or things that we’re 100 percent sure are true. The important thing is that the things that are more likely to be wrong are presented in a more uncertain way. And sometimes we’ll make mistakes even there. Sometimes we’ll present things with certainty that we shouldn’t have. What I would like to be involved in and what I plan to do is to encourage more post-publication critique and correction, reward the whistleblowers who identify errors that are valid and that need to be acted upon, and create more incentives for people to do that, and do that well.

...

2. BAZERMAN: Undoubtedly, I was naive. You know, not only did I trust my colleagues on the signing-first paper, but I think I’ve trusted my colleagues for decades, and hopefully with a good basis for trusting them. I do want to highlight that there are so many benefits of trust. So, the world has done a lot better because we trust science. And the fact that there’s an occasional scientist who we shouldn’t trust should not keep us from gaining the benefit that science creates. And so one of the harms created by the fraudsters is that they give credibility to the science-deniers who are so often keeping us from making progress in society.

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Earlier:

Sunday, January 14, 2024

"Why Is There So Much Fraud in Academia?" Freakonomics interviews Max Bazerman and others

It's a dominant strategy for deferred acceptance proposers to state true preferences in the marriage problem: simple proof

This post is not entirely self-contained, it is in some sense a continuation of and addition to my talk last year at the Simons Institute, which you can see at this link: 

Simple Proofs of Important Results in Market Design-- (video of my talk at Berkeley's Simons Institute)

In that talk (based on work I'm doing with Mike Ostrovsky) I defined the marriage model of Gale and Shapley, gave necessary definitions,  and following the style of their original article, I showed simple, verbal proofs of a number of results, including the constant employment ("lone wolf") theorem:

Constant employment theorem: In a "marriage market"(M,W, P) with strict preferences, the set of people who are single is the same for all stable matchings.

Now based on that theorem, here's a simple proof of the dominant strategy theorem, inspired by a  very short proof (with attributions to Alex Teytelboym and Ravi Jagadeesan) in Nick Arnosti's recent blog post A Short Proof of the Truthfulness of DA by Nick Arnosti 2023/10/01 

Here's the theorem to be proved:

Dominant Strategy Theorem (Dubins and Freedman, Roth): In the M-optimal stable mechanism for the marriage problem (e.g. when the man-proposing deferred acceptance algorithm is used, which produces the most favorable stable matching for every man) it is a dominant strategy for each man i to state a preference list corresponding to his true preferences ≻.

Notation: for any preference ≻′ of player i, an outcome is ≻′-stable if it is stable when i reports ≻′ and everyone else's preferences remain constant.

Proof (following Arnosti)

Suppose that the theorem is false. That is, suppose there exist preferences for all other agents such that when i reports ≻, the resulting ≻-stable matching μ gives μ(i)=w, and when i reports ≻′ ≠ ≻, the resulting ≻′-stable matching μ′ gives μ′(i)=w′≻w. (Note that the final comparison is ≻, i.e. take ≻ to be i's true preference list.)

Consider the market in which i lists w′ as the only acceptable woman (and everyone else's preferences remain fixed). We'll see that this will lead to a contradiction with the constant employment theorem, by implying that there must exist a {w'}-stable matching in which i matches to w′, and another {w'}-stable matching in which i is unmatched. 

1. The matching μ′ assigns i to w′. Because it is ≻′-stable, it must also be {w′}-stable: the only difference between ≻′ and {w'} is that we have removed women from i’s list, which clearly does not create any new blocking pairs.

Note: this step uses only the definition of stability.

2. Let ≻′′ be the deviation in which i truncates ≻ below w′ (i leaves everyone below w′ off of his list), and let μ′′ be the resulting matching.

a. The matching μ′′ leaves i unassigned.  This follows from the fact that, if it matched i, then μ″ would be ≻-stable, since ≻ differs from ≻'' only in that it restores the truncated elements of i's preference, which would be below i's match and hence not introduce any new blocking pairs (since it wouldn't change i's match). But  μ″ can't be ≻-stable,  because w is i’s best ≻-stable partner by assumption, and is worse than all women listed in ≻′′.*

Note: this step uses the definition of stability and fact that μ is optimal for i.

b. Because μ′′  (which leaves i unassigned) is ≻′′-stable, it is also {w′}-stable: the only difference between ≻′′ and {w′} is that we have removed women from i’s list, which does not create any new blocking pairs).

Note: this step uses only the definition of stability.

To recap: μ′ and μ′′ must both be {w′}-stable, but i is matched to w′ by μ′ and unmatched by μ′′ (a contradiction).

This completes the proof.

*Note that the reason μ′′ isn't ≻-stable is that it leaves i unassigned, and so creates new blocking pairs involving i with respect to his true full preferences.

AEA announces changes in how journals will be produced, financed and distributed

Yesterday's AEA Member Announcements include some substantial changes in how the AEA journals will be produced, distributed, and financed.

The AEA will phase out print journals over the next year by no longer offering print subscriptions for members and institutional subscribers as of February 1.  Existing print subscriptions for members and institutions will be honored through January 2025 but will be unable to be renewed.

In line with most other leading journals, the AEA will end payments to referees for reviews invited on or after February 1.

Collecting publication fees from those benefiting most from the AEA publications program distributes costs of the program more equitably than raising submission fees. With this in mind, the AEA will implement a page charge of $15 per typeset page for published articles submitted after February 1, to be paid by authors, and with provisions to waive the fee under certain circumstances. This page charge will not apply to formally solicited manuscripts (such as Presidential addresses) and will not include articles in the Journal of Economic Literature, Journal of Economic Perspectives, or AEA Papers and Proceedings.   

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I wasn't party to these discussions, but I wouldn't be surprised if someone mentioned that per-page charges will feel anachronistic once print journals are no longer produced.  But maybe they will be a mild incentive for brevity (as would per-word charges, which might however inadvertently incentivize sesquipedaleanism).

Hitmen are common in film but otherwise scarce

 The NYT considers the prevalence of hitmen in movies, and why it's hard to find one in real life.

Hit Men Are Easy to Find in the Movies. Real Life Is Another Story.  By Jesse McKinley

"experts in law enforcement and international espionage say that murders-for-hire are notoriously difficult to successfully arrange, let alone get away with.

"Take, for example, what prosecutors say was a recent foiled plot to kill a Sikh separatist in New York City, which American intelligence officials believe was ordered by the Indian government. Once the plot reached the point where the alleged conspirators needed to employ a killer, things got complicated: The would-be hit man turned out to be an undercover agent working for the U.S. government.

...

"Law enforcement officials and academics who study killers-for-hire put them into several large buckets. There are the civilians engaged in everyday murder plots, which often end in sloppy or tragic fashion.

"There are also hit men for the mob, the enforcers working in-house to illegally police the criminal underworld. These killers, perhaps the source of most urban lore about the illicit profession, have been luridly overexposed in shows like “The Sopranos” and films like “The Godfather” and “Goodfellas.”

"Employed in a similar fashion are so-called sicarios, whose use by drug cartels has been heinously prolific at times. And of course there are also the professionals employed by government intelligence agencies, who have been suspected in assassinations in London and elsewhere.

...

"Statistics from the New York State Division of Criminal Justice Services show that in 2022 there were only seven arrests statewide for contract killing, which the state considers first-degree murder. And that was a banner year for arrests for such badness, matching the total for the five previous years combined. Murder for hire is also a federal crime, with penalties ranging from fines and lengthy prison time for failed attempts to life imprisonment or the death penalty “if death results.”

HT: Jlateh Vincent Jappah

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Earlier:

Thursday, February 3, 2022

The market for hitmen

Wednesday, February 2, 2022

Forbidden Transactions and Black Markets

Matching and market design in the latest GEB (stack overflow...)

 The current (January 2024) issue of Games and Economic Behavior presents an increasingly common dilemma (faced by scholars in burgeoning fields, and maybe by aging scholars...). Papers I should read are being written much faster than I can read them.

Here are 9 papers in that issue that are pretty clearly about matching and market design (which leaves out some papers on auctions and one on unraveling of the timing of markets) :

1. Obvious manipulations of tops-only voting rules

   R. Pablo Arribillaga, Agustín G. Bonifacio

   Pages 12-24

   View PDF

2. select article Rejection-proof mechanisms for multi-agent kidney exchange

   Research articleOpen access

   Rejection-proof mechanisms for multi-agent kidney exchange

   Danny Blom, Bart Smeulders, Frits Spieksma

   Pages 25-50

   View PDF

3. 1. Designing rotation programs: Limits and possibilities

      Ville Korpela, Michele Lombardi, Riccardo D. Saulle

      Pages 77-102

      View PDF

   2. select article School choice with transferable student characteristics

      Research articleOpen access

      School choice with transferable student characteristics

      Carmelo Rodríguez-Álvarez, Antonio Romero-Medina

      Pages 103-124

      View PDF

      Auction timing and market thickness

      Isaías N. Chaves, Shota Ichihashi

      Pages 161-178

      View PDF

      
      

      1. School choice with costly information acquisition

         Tyler Maxey

         Pages 248-268

         View PDF

      2. select article Singles monotonicity and stability in one-to-one matching problems

         Research articleOpen access

         Singles monotonicity and stability in one-to-one matching problems

         Yoichi Kasajima, Manabu Toda

         Pages 269-286

         View PDF

      3. select article Reallocation with priorities

         Research articleFull text access

         Reallocation with priorities

         Julien Combe, Jan Christoph Schlegel

         Pages 287-299

         View PDF

         
         

         Coalitional stability in matching problems with externalities and random preferences

         Adriana Piazza, Juan Pablo Torres-Martínez

         Pages 321-339

         View PDF