Tuesday, December 19, 2023

Experimental economics, in Economics textbooks

 Here's a paper surveying introductory economics textbooks for statements (or lack of statements) about experimental economics, over fifty years. (That's just about the period  in which I've been doing experiments, since starting a long collaboration with the late Keith Murnighan  when we were both new assistant professors at the U of I in 1974, although in fact the article covers 1970-2019.)  Note from the figure below that textbooks lag not just the progress of science, but even its widespread recognition: Kahneman and Smith won their Nobel for experiments in 2002.

Changing perceptions about experimentation in economics: 50 years of evidence from principles textbooks, by Saileshsingh Gunessee and Tom Lane, Journal of Behavioral and Experimental Economics, Volume 107, December 2023.

"Abstract: Traditionally, economists often argued experiments play little or no useful role in our science. This paper employs a novel approach to track the historical evolution of this doctrine from 1970 to 2019, by constructing a dataset of 278 introductory economics textbooks. Quantitative and qualitative analysis shows that anti-experimental views were dominant and largely unchanged until 2000, but there has since been a trend towards textbooks making positive statements about experimentation. However, remarks that economic experiments are impossible have been (almost) eliminated only in the last decade, evidencing a sluggish change in perceptions. Supplementary interviews with key textbook authors confirm the historical trend of increased enthusiasm towards experiments, and suggest they are now accepted within the economic mainstream. Our findings hold important implications for how the empirical methodology of economics is understood by practitioners and students."

Based on the introductory chapter of each textbook, they "classified the book's position on economic experiments into one of five categories:

"1. The book's introduction states that doing experiments in economics is impossible, or that economic experiments are never done (hereafter, Impossible/Not Done).

"2. The book's introduction states that doing experiments in economics is difficult, or that economic experiments are rare (hereafter, Difficult/Rare).

"3. The book's introduction states that experiments are done in economics, or refers to economic experiments without mentioning their being rare or any difficulties involved in conducting them (hereafter, Done).

"4. The book's introduction does not mention experimentation in economics (hereafter, No Mention).9


"5. The book does not contain an introductory section (hereafter, No Intro)."



Monday, December 18, 2023

Algorithmic Mechanism Design With Investment, by Akbarpour, Kominers, Li, Li, and Milgrom,

 Mechanisms that are computationally complex may require approximation in implementation, which can change the incentive properties of the exact mechanism.   But progress can be made...

Algorithmic Mechanism Design With Investment, by Mohammad Akbarpour, Scott Duke Kominers, Kevin Michael Li, Shengwu Li, Paul Milgrom, Econometrica, First published: 07 December 2023, https://doi.org/10.3982/ECTA19559

Abstract: We study the investment incentives created by truthful mechanisms that allocate resources using approximation algorithms. Some approximation algorithms guarantee nearly 100% of the optimal welfare in the allocation problem but guarantee nothing when accounting for investment incentives. An algorithm's allocative and investment guarantees coincide if and only if its confirming negative externalities are sufficiently small. We introduce fast approximation algorithms for the knapsack problem that have no confirming negative externalities and guarantees close to 100% for both allocation and investment.

From the introduction:

"Approximation algorithms can be combined with pricing rules to produce truthful mechanisms, provided that the algorithm is “monotone” (Lavi, Mu'Alem, and Nisan (2003)). In this paper, we study the ex ante investment incentives created by such mechanisms.

"Suppose that one bidder can make a costly investment to change its value before participating in a truthful mechanism. As an initial result, we show that all truthful mechanisms using the same allocation algorithm entail the same investment incentives, so we can regard the investment incentives as properties of the algorithm itself.

"If an allocation algorithm exactly maximizes total welfare, then the corresponding truthful mechanism is a Vickrey–Clarke–Groves (VCG) mechanism. For VCG mechanisms, any single bidder's investment is profitable if and only it improves total welfare (Rogerson (1992)). In this respect, the VCG mechanisms are essentially unique. We find that a truthful mechanism aligns a bidder's investment incentives with welfare maximization only if there is some set of allocations such that, for generic valuation profiles, its allocation algorithm exactly maximizes welfare over that set. Many practical approximation algorithms do not have this structure and, as a result, lack efficient investment incentives.

"One might also hope that if an allocation algorithm approximately maximizes total welfare, then it generates approximately efficient investment incentives—but we show to the contrary that arbitrarily good approximations can have arbitrarily bad investment guarantees. To make this statement precise, we evaluate an algorithm's performance on any particular instance by the welfare it achieves divided by the maximum welfare. We refer to the worst-case ratio over all instances when values are exogenous as the allocative guarantee, and the worst-case ratio when one bidder's ex ante investment endogenously determines its value as the investment guarantee.1 (The investment guarantee measures welfare net of investment costs.)

"Because the investment guarantee is a worst case over instances and over investment technologies, it is never more than the allocative guarantee. We characterize the algorithms for which the allocative and investment guarantees are equal, and apply those results to evaluate and improve upon standard approximation algorithms."

Sunday, December 17, 2023

Market Design Workshop 18 - 20 December 2023 Santiago, Chile

 Market Design Workshop  18 - 20 December 2023  Santiago, Chile

Here is the list of participants, and the program

I'll be speaking on Monday and then again on Wednesday.

***********

Unrest and then Covid delayed this conference:

Tuesday, December 17, 2019

Market design workshop in Santiago, SUSPENDED

Politics can certainly get in the way of economics, even academic economics, as it turns out.  The organizers of a conference on matching and market design that I had planned to attend prudently decided  several weeks ago to postpone it, in light of the street demonstrations taking place in Chile.

 

 

 

Friday, December 15, 2023

Who Shall Live? (3rd edition) by Victor R. Fuchs and Karen Eggleston

Shortly before he passed away in September at the age of 99, Vic Fuchs finished the third edition of his book Who Shall Live?, now with a coauthor, Karen Eggleston.

It just came out now, in time for his 100th birthday next month.


********

Sunday, September 17, 2023

Thursday, December 14, 2023

Managing blood supplies by using blood more judiciously

Medpage has the story:

Doing More With Less Blood — Blood management programs can save money and resources  by Steven Frank, MD 

"At Johns Hopkins, since our patient blood management efforts began in 2012, we launched two distinct programs running side by side synergistically. The first program aims to reduce avoidable transfusions for the roughly 99% of patients who accept blood, while the second program provides optimal care for the remaining 1% of patients who wish to avoid transfusion for personal or religious reasons, the vast majority of whom are Jehovah's Witnesses. 
...
"treating preoperative anemia with $4 worth of iron tablets to avoid using $400 worth of blood just makes sense. Wouldn't you rather come to surgery with your own red blood cells, rather than needing a transfusion with someone else's?

""Keeping the blood in the patient" is the other major concept behind patient blood management. Simple things can reduce bleeding, such as keeping patients warm during surgery; lowering the blood pressure (controlled hypotension); tranexamic acid (an inexpensive medication that reduces bleeding by about 30%opens in a new tab or window); Cell Savers to return surgical blood loss to the patient; and using smaller phlebotomy tubes to send lab tests. All of these strategies can be bundled together to achieve this goal.

"After a decade of experience, we crunched the numbers to assess our return on investment (ROI) with our comprehensive patient blood management program, while also looking at patient outcomes. The bottom line was a 7.5-fold ROI, meaning that for every dollar spent on patient blood management, over $7 were either saved or generated in return. This calculation is based on a $3 million annual reduction in blood acquisition cost, along with a $5 million annual net margin on revenue generated by caring for patients under the Center for Bloodless Medicine and Surgery.

"At the same time, clinical outcomes were either the same or better while giving less blood. Heart attack, stroke, thrombotic events, and respiratory and kidney problems were unchanged, while the incidence of hospital-acquired infection decreased. This latter finding is very believable based on high-level evidence (meta-analysis of 18 randomized trials) that transfusions predispose patients to infections. Furthermore, by avoiding transfusions for those who do not need them, we make more blood available for those who really do -- like trauma victims and cancer patients.

"Given the ongoing blood shortages that we are facing, which has been called a "crisis" in the blood industry, patient blood management looks like a giant step towards the triple aim in medicine: improving the patient experience, clinical outcomes, and cost."
**********
See, earlier in the NEJM:

by Harvey G. Klein, M.D., J. Chris Hrouda, B.H.S., and Jay S. Epstein, M.D., October 12, 2017
N Engl J Med 2017; 377:1485-1488
DOI: 10.1056/NEJMsb1706496

Wednesday, December 13, 2023

Black market monkeys for medical research

 Monkeys used in medical research are supposed to come from carefully bred laboratory colonies, but the rising price has led to black markets, which is bad for both monkeys and for medical researchers. (And monkeys are useful for medical research because of their relatively close relation to humans, which makes for difficult conversations regardless of their source...)

The Guardian has the story:

$20,000 monkeys: inside the booming illicit trade for lab animals  by Phoebe Weston

"An international shortage of lab monkeys has driven up prices, incentivising a booming illicit trade. The problem risks undermining research, creating new pandemics, and fuelling wildlife trafficking. As the trade expands, a once-thriving species is now on the edge: in 2022, it was added to the IUCN list of endangered species. Some animal rights activists are calling to end the trade altogether.

"Long-tailed macaques are the most heavily traded primate species in the world, according to a paper published in September, and much of this is for laboratory research. The US National Association for Biological Research says non-human primates remain a critical resource for research, with about 70,000 monkeys imported a year to study infectious diseases, the brain and the creation of new drugs. Difficulty getting monkeys is compromising important research, Sacha says. Before the pandemic he was paying between $2,000 (£1,600) and $5,000 for an animal. Now, it’s about $20,000. “For a couple of years during lockdown it was near impossible to get them,” he says.

"He is not alone. Almost two-thirds of researchers struggled to find monkeys in 2021, according to a report from the US National Academies of Sciences, Engineering, and Medicine, which found that the supply of monkeys for research is at crisis point. According to an article in Science, the report is the “strongest government statement yet on the precarious state of monkey research”. A similar picture is coming from Europe, where a shortage of monkeys has resulted in some research being abandoned.

"Long-tailed macaques (the monkey most commonly used in medical research) are protected under international trade law and special permits are required to import the animals into the US.

"Laboratories need pathogen-free primates that are in good condition and so do not want monkeys that have been wild-caught. With prices so high, however, traffickers are incentivised to catch them in the wild and launder them in via established breeding colonies.

"For decades, China was the largest supplier, but it banned the wild animal trade in 2020 in light of the Covid pandemic. Demand for monkeys increased significantly in the following years, but supply did not. Cambodia has since significantly increased exports to plug the gap and tap into this increasingly lucrative market.

...

"Animal rights campaigners want the US government to end the “cruel trade”, saying it poses a significant threat to public health. The National Academies report says investing in non-animal “organ on a chip” technology could reduce overall demand.

"It also recommended that the US expand its domestic breeding facilities – which it can then regulate. Sacha says: “We shouldn’t be reliant on external countries for these animals that are really critical to our ability to test new therapeutics and vaccines and medicines.”

Tuesday, December 12, 2023

Waiting for HRSA's request for bids to reorganize deceased organ recovery and allocation

Frank McCormick's invaluable email newsletter includes this Bloomberg article on potential bidders who may emerge when HRSA puts out bids to break up the functions that UNOS presently aggregates for managing the deceased donor organ system.  I'm still not at all sure what bids will be forthcoming, especially since the planned request for bids is still quite opaque.

Big Tech, Startups Look to Revamp Troubled Organ Donation System  by Tony Pugh

"Later this fall, the Health Resources and Services Administration plans to solicit bids for the first round of contracts on the OPTN modernization project. The competition will usher in a years-long effort to both stand up new digital technology that better serves the 100,000-plus people on the organ waiting list, while increasing accountability, equity, and efficiency in the way organs are recovered, matched, and transplanted."

Often when I see a short quote broken up into even smaller pieces I worry that it might not accurately represent what was actually said, but this quote is spot on:

When I look at” the current software used to match organs with possible recipients and to send accept-or-refuse offers to transplant surgeons, “it reminds me of the 1980s,” said Nobel Prize-winning Stanford University economist Alvin E. Roth, who studies how kidneys are matched with suitable candidates.


Monday, December 11, 2023

Market Design and Maintenance (new NBER working paper, from a conference)

This paper began as a presentation at the NBER conference on New Directions in Market Design, in the Spring of 2023

 Market Design and Maintenance by Alvin E. Roth.  NBER WORKING PAPER 31947
DOI 10.3386/w31947, ISSUE DATE December 2023

Abstract: Because no marketplace operates in isolation from the larger world, marketplace designs may need to adapt to changes in the larger environments. I discuss such changes in connection with the labor markets for new doctors, new Ph.D. economists, and for kidney exchange transplants. But while practical market design presents a host of challenges, it also offers many rewards. Among the rewards to market designers themselves is the opportunity to become intimately familiar with markets that shape the lives and careers of their participants.

************
There will eventually be a conference volume published by U. Chicago Press, and some of the papers are already online, and slides and  videos from the conference are here.

Sunday, December 10, 2023

Signaling for residency programs in dermatology, general surgery, and internal medicine

We're starting to see some data from signaling for residency applications.  This paper observes that programs are more likely to interview candidates who send them a signal. (Economists will worry that this reflects which programs are signaled and not just the effect of a signal...)  These three specialties have relatively few signals, more like economics than like Orthopedic Surgery (which has 30 signals).  And the table indicates that more interviews are offered than signals received, so that's another difference from Ortho...)

Rosenblatt, Adena E., Jennifer LaFemina, Lonika Sood, Jennifer Choi, Jennifer Serfin, Bobby Naemi, and Dana Dunleavy. "Impact of Preference Signals on Interview Selection Across Multiple Residency Specialties and Programs." Journal of Graduate Medical Education 15, no. 6 (2023): 702.

"Abstract

"Background Program signaling is an innovation that allows applicants to express interest in specific programs while providing programs the opportunity to review genuinely interested applicants during the interview selection process.

"Objective To examine the influence of program signaling on “selected to interview” status across specialties in the 2022 Electronic Residency Application Service (ERAS) application cycle.

"Methods Dermatology, general surgery-categorical (GS), and internal medicine-categorical (IM-C) programs that participated in the signaling section of the 2022 supplemental ERAS application (SuppApp) were included. Applicant signal data was collected from SuppApp, applicant self-reported characteristics collected from the MyERAS Application for Residency Applicants, and 2020 program characteristics collected from the 2020 GME Track Survey. Applicant probability of being selected for interview was analyzed using logistic regression, determined by the selected to interview status in the ERAS Program Director’s WorkStation.

"Results Dermatology had a 62% participation rate (73 of 117 programs), GS a 75% participation rate (174 of 232 programs), and IM-C an 86% participation rate (309 of 361 programs). In all 3 specialties examined, on average, signaling increased the likelihood of being selected to interview compared to applicants who did not signal. This finding held across gender and underrepresented in medicine (UIM) groups in all 3 specialties, across applicant types (MDs, DOs, international medical graduates) for GS and IM-C, and after controlling for United States Medical Licensing Examination Step 1 scores.

"Conclusions Although there was variability by program, signaling increased likelihood of being selected for interview without negatively affecting any specific gender or UIM group."



Data from future years will be needed to determine how signaling is influencing the distribution of residents to programs.

Saturday, December 9, 2023

JOE Job Openings for Economists: 2023 versus the past 4 years

 Here's the latest note on the job market from the AEA's  Committee on the Job Market.  It reflects a tight job market (but may also reflect that fewer than 100% of available jobs are published in the JOE, and this may be in flux). The full memo is at the link below, and I'm summarizing here some of the highlights (trigger warning:(

JOE Job Openings by Sector, 2023 versus the past 4 years 

"To: Members of the American Economic Association

From: AEA Committee on the Job Market: John Cawley (chair), Matt Gentzkow, Brooke Helppie-McFall, Al Roth, Peter Rousseau, and Wendy Stock  Date: December 8, 2023

This memo reports the cumulative number of unique job openings on Job Openings for Economists (JOE), by sector and week, compared to the same week in recent years.

Some clarifications on the data and graphs in this memo:

• ...

• The data described in this memo cover ISO weeks 1 through 48, which in 2023 ended December 3.

• The counts that are graphed and discussed are the number of job openings. To clarify, it is not the number of job listings; a listing may include multiple openings.

• ...

• On each graph, the year-to-date cumulative number of job openings is listed for the past five years separately: 2019-2023. The graphs are shown below, overall and by sector. 

Figure 1 (on p. 3) shows the total number of job openings in 2023, compared to recent years. As of the end of week 48, there have been 2,924 jobs listed on JOE since the beginning of 2023, which is 14.7% lower than at the same week in 2022, 8.7% lower than the same week in 2021, 21.9% higher than the same week in 2020 (the worst COVID year), and 15.9% lower than the same week in 2019, the last pre- COVID year.

Subsequent graphs compare the number of job openings separately by sector. Figure 2 shows that 741 full-time academic positions in the U.S. have been listed on JOE so far in 2023; this is 16.5% lower than at the same week in 2022, 0.4% lower than at the same week in 2021, 109.3% higher than at the same week in 2020, and 8.2% lower than the same week in 2019 - see p. 4.

Figure 4 shows that 949 full-time academic job openings in institutions outside the U.S. have been listed on JOE so far in 2023; that is 7.2% lower than at the same week in 2022, 9.5% lower than the same week in 2021, 11.1% higher than at the same week in 2020, and 16.7% lower than the same week in 2019 - see p. 6.

Figure 6 shows that 508 full-time non-academic positions (in the U.S. or abroad) have been listed on JOE so far in 2023; that is 26.8% lower than at the same week in 2022, 30.0% lower than at the same week in 2021, 18.2% lower than the same time in 2020 and 35.4% lower than the same week in 2019 - see p. 8.

Over the past four years, roughly 92% of the calendar year’s job listings have been posted by the end of November. In January 2024, we will post a year-end report that includes the final numbers for 2023.

The AEA Executive Committee and the Committee on the Job Market provide the following guidance for the job market, to ensure common expectations, fairness, and a thick job market. This guidance concerns the timing of interview invitations, the interviews themselves, and exploding job offers.

...






Friday, December 8, 2023

Computers in Econ (and in market design)

 The current issue of the journal Œconomia. is devoted to The Computerization of Economics. Computers, Programming, and the Internet in the History of Economics

It includes this surprisingly grumpy-sounding take on market design, particularly on its intersection with game theory:

 Nik-Khah, Edward. "The Closed Market: Platform Design and the Computerization of Economics." Œconomia. History, Methodology, Philosophy 13-3 (2023): 877-905.

Here's a paragraph that caught my eye:

"In his book Who Gets What—And Why, the market designer Alvin Roth pronounced firms such as Google, Amazon, and Uber to be “markets,” proclaiming, “Successful designs depend greatly on the details of the market, including the culture and psychology of the participants” (Roth, 2015). One need not actually find an example of an economist counseling advisees to skip that additional course in game theory and take up cultural anthropology to arrive at the sense that matters had taken a surprising turn: only a decade before one regularly encountered brash claims that all social science worth its salt must be reducible to game theory, with market design cited as evidence for why this must be so (e.g., Binmore, 2004)."

#####

Here's the table of contents of the issue:

Thursday, December 7, 2023

Drug addiction: not just opioids

 Consumption of addictive drugs seems to come in deadly cocktails these days, which is making interdiction of drugs, and treatment of addiction more complicated.

The NYT has the story:

‘A Monster’: Super Meth and Other Drugs Push Crisis Beyond Opioids. Millions of U.S. drug users now are addicted to several substances, not just opioids like fentanyl and heroin. The shift is making treatment far more difficult.  By Jan Hoffman

"The United States is in a new and perilous period in its battle against illicit drugs. The scourge is not only opioids, such as fentanyl, but a rapidly growing practice that the Centers for Disease Control and Prevention labels “polysubstance use.”

Over the last three years, studies of people addicted to opioids (a population estimated to be in the millions) have consistently shown that between 70 and 80 percent also take other illicit substances, a shift that is stymieing treatment efforts and confounding state, local and federal policies.

“It’s no longer an opioid epidemic,” said Dr. Cara Poland, an associate professor at the Michigan State University College of Human Medicine. “This is an addiction crisis.”

...

"The incursion of meth has been particularly problematic. Not only is there no approved medical treatment for meth addiction, but meth can also undercut the effectiveness of opioid addiction therapies. Meth explodes the pleasure receptors, but also induces paranoia and hallucinations, works like a slow acid on teeth and heart valves and can inflict long-lasting brain changes.


"The Biden administration has been pouring billions into opioid interventions and policing traffickers, but has otherwise lagged in keeping pace with the evolution of drug use. There has been comparatively little discussion about meth and cocaine, despite the fact that during the 12-month period ending in May 2023, over 34,000 deaths were attributed to methamphetamine and 28,000 to cocaine, according to provisional federal data.

...

"Like opioids, which originally came from the poppy, meth started out as a plant-based product, derived from the herb ephedra. Now, both drugs can be produced in bulk synthetically and cheaply. They each pack a potentially lethal, addictive wallop far stronger than their precursors."

Wednesday, December 6, 2023

Applying for medical residencies: a consensus statement from Internal Medicine

 The Alliance for Academic Internal Medicine has released a "consensus statement" with many proposals about application and interview caps, and signaling.

Catalanotti, Jillian S., Reeni Abraham, John H. Choe, Kelli A. Corning, Laurel Fick, Kathleen M. Finn, Stacy Higgins et al. "Rethinking the Internal Medicine Residency Application Process to Prioritize the Public Good: A Consensus Statement of the Alliance for Academic Internal Medicine." The American Journal of Medicine (2023).

It also includes a call for data and analysis:

"AAIM proposes increasing internal medicine program preference signals to 15, using tiered signaling with three “gold” and 12 “silver” signals, and setting an interview cap of 15 in the 2024-2025 recruitment season, with participation by all internal medicine programs. The Alliance recommends that all internal medicine programs participate in ACI. AAIM recommends that programs transparently share information about their use of preference signals and other application screening methods and calls for real-time data analysis to explore impact, inform future iterations and identify potential harms.

"The Alliance calls upon ERAS and NRMP as well as Thalamus® and other interview scheduling platforms to transparently share data, to embrace change, and to perform analyses needed to inform this process. For example, recent modeling with eight years of retrospective NRMP data in OBGYN demonstrated that an early match round may increase the number of “mutually dissatisfied applicant-program pairs” and that a multiple-round match process could introduce potential rewards for gamesmanship, a prime factor addressed by the current process.35 AAIM applauds this analysis and hopes that the new collaboration between ERAS and Thalamus® may provide useful interview data to inform this proposal and further interventions."

And here is reference 35 in that last paragraph, about which I've blogged before.

I Ashlagi, E Love, JI Reminick, AE. Roth
Early vs Single Match in the Transition to Residency: Analysis Using NRMP Data From 2014 to 2021
J Grad Med Educ, 15 (2) (Apr 2023), pp. 219-227, 10.4300/JGME-D-22-00177.1

Tuesday, December 5, 2023

Organ & Body Donations: John Oliver

Laugh through the tears with John Oliver:

Monday, December 4, 2023

Convalescent plasma: the picture is getting clearer

 Slowly, there is evidence accumulating that convalescent plasma is helpful in treating patients with severe Covid, if it is administered early.  There is also evidence that it doesn't help much once the disease has become well established, particularly when the primary symptoms become due to the body's own immune reaction.  These caveats help explain why early reports did not find an effect of convalescent plasma--i.e. it helped only a subset of the patients to whom it was administered. But for those it was sometimes life saving. Here is a recent paper from the New England Journal of Medicine.

Convalescent Plasma for Covid-19–Induced ARDS in Mechanically Ventilated Patients by Benoît Misset, M.D., Michael Piagnerelli, M.D., Ph.D., Eric Hoste, M.D., Ph.D., Nadia Dardenne, M.Sc., David Grimaldi, M.D., Ph.D., Isabelle Michaux, M.D., Ph.D., Elisabeth De Waele, M.D., Ph.D., Alexander Dumoulin, M.D., Philippe G. Jorens, M.D., Ph.D., Emmanuel van der Hauwaert, M.D., Frédéric Vallot, M.D., Stoffel Lamote, M.D., et al., October 26, 2023, N Engl J Med 2023; 389:1590-1600 DOI: 10.1056/NEJMoa2209502

"Abstract

BACKGROUND

Passive immunization with plasma collected from convalescent patients has been regularly used to treat coronavirus disease 2019 (Covid-19). Minimal data are available regarding the use of convalescent plasma in patients with Covid-19–induced acute respiratory distress syndrome (ARDS).

METHODS

In this open-label trial, we randomly assigned adult patients with Covid-19–induced ARDS who had been receiving invasive mechanical ventilation for less than 5 days in a 1:1 ratio to receive either convalescent plasma with a neutralizing antibody titer of at least 1:320 or standard care alone. Randomization was stratified according to the time from tracheal intubation to inclusion. The primary outcome was death by day 28.

RESULTS

A total of 475 patients underwent randomization from September 2020 through March 2022. Overall, 237 patients were assigned to receive convalescent plasma and 238 to receive standard care. Owing to a shortage of convalescent plasma, a neutralizing antibody titer of 1:160 was administered to 17.7% of the patients in the convalescent-plasma group. Glucocorticoids were administered to 466 patients (98.1%). At day 28, mortality was 35.4% in the convalescent-plasma group and 45.0% in the standard-care group (P=0.03). In a prespecified analysis, this effect was observed mainly in patients who underwent randomization 48 hours or less after the initiation of invasive mechanical ventilation. Serious adverse events did not differ substantially between the two groups.

CONCLUSIONS

The administration of plasma collected from convalescent donors with a neutralizing antibody titer of at least 1:160 to patients with Covid-19–induced ARDS within 5 days after the initiation of invasive mechanical ventilation significantly reduced mortality at day 28. This effect was mainly observed in patients who underwent randomization 48 hours or less after ventilation initiation."

#####

Here are my posts on convalescent plasma, and the confusing initial reports about its effects.