Pediatric Heart Transplants: rethinking the waitlist, by Power, Sweat...Almond et al.

 Here's a paper on the design of the waitlist for pediatric heart transplants.  It's accompanied by an editorial in the journal, and a discussion at Stanford Medical School.

Here's the article

Alyssa Power, MD,a,* Kurt R. Sweat, PHD,b,* Alvin Roth, PHD,b John C. Dykes, MD,a Beth Kaufman, MD,a Michael Ma, MD,c Sharon Chen, MD, MPH,a Seth A. Hollander, MD,a Elizabeth Profita, MD,a David N. Rosenthal, MD,aLynsey Barkoff, NP,a Chiu-Yu Chen, MD, PHD,a Ryan R. Davies, MD,d Christopher S. Almond, MD, MPH, Contemporary Pediatric Heart Transplant Waitlist Mortality  Journal of the American College of Cardiology, Volume 84, Issue 7, 13 August 2024, Pages 620-632

ABSTRACT

BACKGROUND In 2016, the United Network for Organ Sharing revised its pediatric heart transplant (HT) allocation policy.

OBJECTIVES This study sought to determine whether the 2016 revisions are associated with reduced waitlist mortality and capture patient-specific risks.

METHODS Children listed for HT from 1999 to 2023 were identified using Organ Procurement and Transplantation Network data and grouped into 3 eras (era 1: 1999-2006; era 2: 2006-2016; era 3: 2016-2023) based on when the United Network for Organ Sharing implemented allocation changes. Fine-Gray competing risks modeling was used to identify factors associated with death or delisting for deterioration. Fixed-effects analysis was used to determine whether allocation changes were associated with mortality.

RESULTS Waitlist mortality declined 8 percentage points (PP) across eras (21%, 17%, and 13%, respectively; P < 0.01). At listing, era 3 children were less sick than era 1 children, with 6 PP less ECMO use (P < 0.01), 11 PP less ventilator use (P < 0.01), and 1 PP less dialysis use (P < 0.01). Ventricular assist device (VAD) use was 13 PP higher, and VAD mortality decreased 9 PP (P < 0.01). Non-White mortality declined 10 PP (P < 0.01). ABO-incompatible listings increased 27 PP, and blood group O infant mortality decreased 13 PP (P < 0.01). In multivariable analyses, the 2016 revisions were not associated with lower waitlist mortality, whereas VAD use (in era 3), ABO-incompatible transplant, improved patient selection, and narrowing racial disparities were. Match-run analyses demonstrated poor correlation between individual waitlist mortality risk and the match-run order.

CONCLUSIONS The 2016 allocation revisions were not independently associated with the decline in pediatric HT waitlist mortality. The 3-tier classification system fails to adequately capture patient-specific risks. A more flexible allocation system that accurately reflects patient-specific risks and considers transplant benefit is urgently needed. 

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Here's the accompanying editorial in JACC

Getting to Transplant Should Not Be the Goal, by David L.S. Morales MD and Benjamin S. Mantell MD, PhD

And here's the Stanford article:

Heart transplant list doesn’t rank kids by medical need, Stanford Medicine-led study finds. More babies and children survive the wait for a heart transplant than in the past, but improvements are due to better medical care, not changes to wait-list rules, a new study finds. August 5, 2024 - By Erin Digitale

“The current system is not doing a good job of capturing medical urgency, which is one of its explicit goals,” said the study’s co-lead author, economist Kurt Sweat, PhD, who conducted the research as a graduate student in economics at Stanford University. "

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Kurt's job market paper was on heart transplants for adult patients.

Friday, April 26, 2024

Kurt Sweat defends his dissertation

Update: here's another commentary on the article:

Fewer Kids Now Die While Awaiting Heart Transplant, but There’s Room for Improvement Twenty years of data show mortality has dropped. Still, with one in eight children dying on the wait list, more needs to be done.  By Yael L. Maxwell

How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?

 Here's a report on the effects of helping living organ donors with their expenses.

Mandell, Rebecca J., Abigail R. Smith, Kimberly A. Gifford, Barry A. Hong, Nathan P. Goodrich, Amit K. Mathur, Melissa A. Fava, Akinlolu O. Ojo, and Robert M. Merion. "How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?" Progress in Transplantation (2024): 15269248241268679.

Abstract: Introduction: Living donation increases the organ supply, but associated non-medical expenses can disincentivize donation. Programs aimed at increasing living donation need to better understand how financial obstacles, including lost wages, impact the decision to pursue donation. Methods/Approach: Forty-eight interviews were conducted and analyzed using a grounded theory approach. Findings: Three key themes were identified that influenced decision-making: emotional attachment, temporal flexibility, and job security. These themes emerged when dividing interview participants into 3 groups: close relationship donors, broader network donors, and non-directed donors, representing donation to a family member or friend, a specific person they do not know well or at all, or a non-specified individual, respectively. Most close relationship donors wanted to donate regardless of personal financial cost, based on emotional attachment to the recipient. Wage reimbursement did not typically affect their decision-making but could reduce stress. Since non-directed donors did not donate to a specific individual, they could wait to achieve financial stability before donating, if needed. While wage reimbursement might create more proximate stability, non-directed donors had the flexibility to postpone donations until they could independently achieve financial stability. Lacking emotional attachment and temporal flexibility, broader network donors were particularly active decision-makers and most influenced by wage reimbursement. Across all groups, donors with job security were more resolute about donating. Conclusion: The findings underscore the importance of lost wage reimbursement to facilitate donation and reduce stress, and policies to protect donor job security."

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Related posts:

Thursday, March 31, 2022

National Living Donor Assistance Center (NLDAC) support for lost wages and dependent care

Saturday, September 17, 2022

Non-directed organ donors and NLDAC financial support

Interviews, flyouts and offers in the job market for new PhD economists, 2024-25

 We may still be in a period of disequilibrium in the conduct of the market for new economists, as Zoom interviews have replaced in-person interviews at the annual January ASSA meetings.  In an attempt at maintaining market thickness, the AEA has reaffirmed its guidelines, as discussed in the email below that went out to AEA members yesterday

AEA Guidance on the 2024-25 Economics Job Market Cycle

Date: August 5, 2024 To: Members of the American Economic Association From: Peter L. Rousseau, Secretary-Treasurer The AEA Executive Committee, in conjunction with its Committee on the Job Market, recognizes that it is to the benefit of the profession if the job market for economists is thick, with many employers and job candidates participating in the same stages at the same time. Moreover, the AEA's goals of diversity, equity, and inclusion are fostered by having a timeline that remains widely known and accepted, ensuring that candidates can correctly anticipate when each stage will occur. The AEA has a role to establish professional norms, which includes ensuring fair treatment of job candidates, including that they have enough time to consider job offers. With these goals in mind, and in light of inquiries from both job candidates and employers about how to proceed, the AEA asks that departments and other employers consider the following timeline for initial interviews and “flyouts” in the upcoming job cycle (2024-25). Timing of interview invitations The AEA suggests that employers wait to extend interview invitations until the day after job market signals are transmitted to employers (planned for December 4). Rationale: the AEA created the signaling mechanism to reduce the problem of asymmetric information and allow job candidates to credibly signal their interest to two employers. The AEA asks that employers wait to extend interview invitations until those signals have been transmitted, and to use that information to finalize their set of candidates to interview. This helps the job market in several ways: it reduces the problem of imperfect information, it helps ensure a thick market at each stage, and it promotes the AEA’s goals of diversity, equity, and inclusion. Job candidates from historically under-represented groups may lack informal professional networks and thus may especially rely on the signals to convey their interest. Waiting to review the signals before issuing invitations promotes a fairer, more equitable process. We also ask that all employers indicate on EconTrack when they have extended interview invitations. This allows candidates to learn about the status of searches without visiting websites posting crowd-sourced information and potentially inappropriate other content. Timing of interviews Initial interviews may take place any time after the AEA signals are sent (planned for December 4). The AEA recommends that all initial interviews take place virtually (e.g., by Zoom). We suggest that interviews not take place during the ASSA meeting itself (January 3-5, 2025). Rationale: In the past, interviews were conducted in-person at the ASSA meetings. This promoted thickness of the market, because most candidates and employers were present at the meetings but had the disadvantage of precluding both job candidates and interviewers from fully participating in sessions. Initial job interviews went online during COVID, and feedback indicated that the benefits of virtual first-round interviews (e.g., low monetary cost, zero cost in travel time, scheduling flexibility, convenience) outweighed the limitations (e.g., less rich interaction). We ask that interviews NOT take place during the ASSA meetings (January 3-5, 2025) in order to allow job candidates and interviewers to participate in the conference. Timing of flyouts Flyouts have historically happened at times appropriate for the employer, and the AEA sees no reason to suggest otherwise. We ask that all employers indicate on EconTrack when they have extended flyout invitations. Unlike with interviews, the AEA does not take a position on whether flyouts should be virtual or in-person. Timing of offers and “exploding” offers In order to ensure that the job market remains sufficiently synchronized and thick, and that candidates have a chance to compare offers, the AEA recommends that employers leave job offers open (i.e. do not require candidates to accept or decline) until at least January 31. The AEA also strongly recommends that employers give candidates at least two weeks to consider their job offer. We recognize that offers made late in the job market season (e.g., March or later) may be of shorter duration. In some circumstances, employers are under heavy pressure to give less time to candidates for various reasons. If that is absolutely necessary, we recommend that employers give candidates a minimum of one week to consider the offer, and that candidates be given advance notice of this (e.g., at the flyout stage) whenever possible. Rationale: Recently, there is concern about a rise in “exploding offers” – i.e., offers for which candidates are given too few days to sufficiently consider the offer and their alternatives. This can prevent candidates from learning about their options or comparing offers, and at the extreme can be coercive. Giving candidates two weeks (or, late in the job market season, at least one week) to consider an offer is a reasonable standard. We also ask that all employers indicate on EconTrack when they have completed or closed their search. Job market institutions and mechanisms Please keep in mind the various job market institutions and mechanisms created by the AEA to improve the job market: The JOE Network includes a database of job openings for economists. Employers may sign up here: https://www.aeaweb.org/joe/employer. Job candidates may search the database here: https://www.aeaweb.org/joe/listings. The JOE Network has an electronic clearinghouse for job candidates to submit job applications. Job candidates may register here: https://www.aeaweb.org/joe/candidate. The AEA Committee on the Job Market releases data and guidance on the job market here: https://www.aeaweb.org/joe/communications. EconTrack: a board on which employers can indicate when they have extended interview and flyout invitations, and closed their search: https://www.aeaweb.org/econtrack.   Thank you for helping to ensure a transparent and equitable job market for new Ph.D. economists.

Theory brunch at Stanford

 A Sunday brunch to welcome Fuhito Kojima back for a summer visit brought together an eclectic group of Stanford theorists, past, present, and future. (Mike Ostrovsky, Mohammad Akbarpour and Bob Wilson had already run off before things settled down for this picture  of Fuhito Kojima, Ilya Segal, Itai Ashlagi, Jason Hartline, Ravi Jagadeesan, Oguzhan Celebi, Roberto Corrao, and Frank Yang.)

Remembering Jim Simons

 Here's the memorial page from the Simons Institute for the Theory of Computing

Remembering Jim Simons

HT: Vijay Vazirani

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Earlier:

Saturday, May 11, 2024

Jim Simons (1938-2024)

Goldin arm

 Here's a great post-Nobel story from the Harvard Gazette.

Time to send in Goldin. Sox go with Nobel laureate southpaw to throw out first pitch by Jill Radsken 

“I’ve been throwing balls my whole life, but it’s been pitching to a dog with its mouth open 25 feet away. Using a real baseball has more heft,” said Goldin, the Henry Lee Professor of Economics."

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Memory lane:

Sunday, October 28, 2012

The Nobel sport of football at Stanford

Barter of Russians in prison for prisoners in Russia--Redemption of Captives

 Barter is alive and well in diplomacy, as evidenced by yesterday's multi-country multi-party prisoner swap.  Among the highlights was a journalist for a hitman.

The Washington Post has the story, with multiple headlines.

Biden: Prisoner swap ‘a feat of diplomacy’. U.S. reporter, others freed in complex, landmark, multicountry exchange with Russia

U.S., Germany trade convicted assassin to Russia for political prisoners in major swap The landmark prisoner swap freed Russians jailed in the West, including a convicted killer, . for U.S. journalist Evan Gershkovich, dissident Vladimir Kara-Murza and others. By Shane Harris, Yasmeen Abutaleb, Mary Ilyushina and Souad Mekhennet, August 1, 2024

"In the largest prisoner exchange since the height of the Cold War, officials of the United States, Russia, Germany and other countries met on an airfield in Ankara, Turkey, on Thursday and swapped at least 24 people — capping months of painstaking diplomacy involving negotiations at the highest levels of nine governments.

"Those released included a Russian assassin convicted of murder in Berlin; the American journalist Evan Gershkovich, who was accused of espionage without any known evidence; and several Russian dissidents whose only misdeed was demanding freedom and democracy or criticizing the war in Ukraine, including Vladimir Kara-Murza, a Washington Post Opinions contributor.

"White House officials called it the largest and most complicated international prisoner exchange in decades, and one of the biggest diplomatic accomplishments of Joe Biden’s presidency... But the deal was also fraught, raising questions about the West’s willingness to deal with authoritarian regimes that imprison innocen..t people for negotiating leverage."

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All the exchanged prisoners were serving time, so this could be viewed as a bizarre variety of the time swaps in yesterday's post.

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Pidyon shvuyim (Hebrew: פִּדְיוֹן שְׁבוּיִים, literally: Redemption of Captives) is a religious duty in Judaism to free hostages. Historically, many captives have been redeemed, as when Jewish refugees were brought out from behind the Iron curtain with payments to the governments preventing them from emigrating.  (At equilibrium, this means Jews are often taken hostage, as  in the Hamas attack on October 7.)

Time banking

 Here's the latest Freakonomics podcast, on time banking. Dubner interviews some proponents, and a skeptic. I was the skeptic. It's not that I think time banking is a bad idea, I think it's a good idea, but a good idea like Esperanto, not a good idea like money... 

The World’s Most Valuable Unused Resource. It’s not oil or water or plutonium — it’s human hours. We’ve got an idea for putting them to use, and for building a more human-centered economy. But we need your help.

One of the proponents is Andrew Yang.

Here's an excerpt from the transcript

"YANG: Yeah, the best example I can use is that punch card at your local deli where you get 10 sandwiches, and you get the 11th for free. That has a place of honor in your wallet. And you get really excited when you get close to the free sandwich. If you can imagine a version of the deli punch card for showing up to all sorts of things like that’s the vision. Americans love points. Americans love rewards. Americans love stuff. I have these reward points on my Amex, and it’s mesmerizing, even though right now, it doesn’t cost them anything because I’m not going to redeem it because I’m hoarding for — I don’t know what I’m hoarding for. That’s really the core idea, is that if you give Americans cumulative rewards for doing awesome stuff, you’ll see more awesome stuff.

Okay, so who could possibly be against a scheme that rewards people for doing awesome stuff? Well, there is a certain Nobel Prize-winning economist.

ROTH: Some people’s time might be more valuable than other people’s.

That’s coming up.

*      *      *

As appealing as the idea of time banking is to me, and to Andrew Yang, most economists think that money is a much better measure of value than time. Here, again, is Al Roth.

ROTH: Time is an interesting commodity, and we buy and sell it all the time. When you hire a lawyer, he bills you by the hour. You give him money for his time and expertise. You might hire someone to house-sit for you, and water your plants while you’re away. So we trade time a lot, but not for time. And part of the reason is that time is sort of a clunky commodity. It’s a lot easier to trade other things.

DUBNER: But why is it so clunky? I mean, just as a dollar is a dollar, an hour is an hour.

ROTH: Well, one of the things we worry about with monetary markets is, some people have more dollars than other people do, and that gives them more access. And maybe we don’t always feel great about that. And so I think some of the charm to people who are charmed by time banks is that everyone has 24 hours in a day. But, you know, a working mother of three kids has less time than a retired banker who has a cleaner coming to his house, and a gardener. So not everyone has the same amount of time. And it’s clunky because it’s also hard to transfer. There’s the joke about the lawyer who goes to see a dentist, and the dentist fills his cavity in 10 minutes. The lawyer says to him, “You make more per hour than I do.” And the dentist says, “Would you prefer that I took an hour?”

DUBNER: So we solicited a few other economists to come on the show to talk about time banking. One of them, who shall go unnamed, wrote back to say: “The more I think about it, the more I think it is the dumbest idea in the world.” So do you hate the idea as much as that economist?

ROTH: I don’t hate it as much as that economist. By and large, I think that finding more opportunities for valuable exchange, for exchange that improves welfare on both sides, is a good thing. So I certainly have nothing against swapping time for time. I just don’t think of it as a scalable way to run a significant part of the economy.

DUBNER: The reason the idea appeals to me is because I’ve spent a lot of time with people like you, economists. And when you get a little bit off the beaten path, you start thinking about things like shadow time, right, the hours I have when I’m not on the clock, and what they’re worth to me and how I could spend them. And then I also just think about human capital, which economists are always going on and on about. It feels like that’s the purpose of a lot of economic research these days, is to show how important it is for people to build human capital through education and social networks and so on, because human capital is indeed really valuable. But then when I look around the world, I see so much surplus, dare I say, wasted human capital. People who are able to do things that may not be that valuable in a regular market circumstance, and may not even be that valuable to them, but might be very valuable to other people. And wouldn’t it be wonderful to find a way to give value to that surplus human capital? I mean, if you add it all up, that could be the biggest natural resource in the world, worth more than all the petroleum and other mineral products combined. And then I thought, well, who out there in the world would appreciate that more than Al Roth, who recognized that there is surplus sitting around in people’s bodies, for instance, in the form of a second kidney, and found a way to set up a system to make those extra kidneys available. So does that make time banking a tad more viable in your view?

ROTH: Well, I already said that I am in favor of looking for ways to increase valuable exchanges. So when time for time works, that’s great. But when you talk about human capital, you’re already suggesting that on some tasks, some people’s time might be more valuable than other people’s, because they have more human capital. And that’s what makes time clunky, if all we’re doing is swapping time. You know, I live on a college campus, so we trade time all the time, by inviting people to dinner. And then they invite us back to dinner. Dinner is sort of time, you expect you’re going to spend two, two-and-a-half hours with people and create connections that can’t be monetized. And it’s part of what makes life worth living. And if they had to eat and run, it would be a less-successful dinner. 

...

DUBNER: But I could imagine a scenario where, let’s say, there’s a person running a roofing business, maybe they’re second- or third-generation even. And they’ve decided that the way forward is to do solar installations. You’re in California. I’m sure there’s a big market for that there. But they don’t really know how to set up their business to optimize for that. They don’t know what kinds of partnerships, and maybe there’s some tax strategy, and just setting up the business that they’re not clear on. But boy, Professor Roth, he loves to talk to people about problems like that. And he also needs a new roof. So that sounds like a really nice possible exchange that could happen in the time bank. Would you be open to discussing that?

ROTH: I’d be open to discussing it.

DUBNER: He said, reluctantly.

ROTH: I say reluctantly because I certainly wouldn’t want that to be the only way I could get my roof repaired. "

Crowding in School Choice, By William Phan, Ryan Tierney, and Yu Zhou

 Here's an innovative paper in the latest AER.

The authors use North Carolina's Wake County Public School System as a motivating example of crowding and the information available to parents about crowding.

Crowding in School Choice, By William Phan, Ryan Tierney, and Yu Zhou, American Economic Review 2024, 114(8): 2526–2552, https://doi.org/10.1257/aer.20220626

Abstract: "We consider the market design problem of matching students to schools in the presence of crowding effects. These effects are salient in parents’ decision-making and the empirical literature; however, they cause difficulties in the design of satisfactory mechanisms and, as such, are not currently considered. We propose a new framework and an equilibrium notion that accommodates crowding, no-envy, and respect for priorities. The equilibrium has a student-optimal element that induces an incentive-compatible mechanism and is implementable via a novel algorithm. Moreover, analogs of fundamental structural results of the matching literature (the rural hospitals theorem, welfare lattice, etc.) survive."

"In our model, each student has a preference over the two dimensions of school identity and the total amount of educational resources that they consume at each school. The more crowded a school is, the fewer resources each student enjoys, and so the value of this second dimension at each school will emerge endogenously. 

...

"We propose a new equilibrium concept: rationing crowding equilibrium (RCE). The core of our innovation is in realizing that the vector of resource levels can function like a price. Consider a competitive solution applied in our context. We may imagine that an auctioneer announces a resource vector, which then determines a (finite) list of school and resource-level pairs. Each student will then demand (generically) one of these pairs, and we can ask the usual market clearing question: Does there exist a resource vector at which, for each school, the demand for educational resources is equal to its supply? We show that the answer is yes, if we allow for an error of at most one seat.9,10 Since each student faced the same budget set, the resulting allocation satisfies no-envy, at least for schools that have not reached their enrollment cap

Danny Kahneman, remembered by Stanford's Center for Advanced Study in the Behavioral Sciences

 Daniel Kahneman, 1934-2024: Nobel Prize Winner & CASBS Legend

"Daniel Kahneman, the Nobel laureate, professor emeritus of psychology and public affairs at Princeton University, and among the most distinguished and consequential cognitive and behavioral scientists of the past half-century, passed away on March 27, 2024. He was 90.

"Daniel Kahneman was a CASBS fellow during the 1977-78 academic year, occupying office (called “studies” at CASBS) #6. (Notably, this remarkable class included two other future Nobel Prize winners – Oliver Williamson (2009) and Robert B. Wilson (2020) – as well as future Supreme Court Justice Ruth Bader Ginsburg.)

"Kahneman’s 1977-78 year is legendary for two reasons. First, it is here, at CASBS, where Kahneman and his principal collaborator of nearly a decade, Amos Tversky – who had a visiting appointment at Stanford University’s psychology department that year[1] – completed a paper they painstakingly had been working on for years: “Prospect Theory: An Analysis of Decision under Risk.” The paper, published in March 1979 in the journal Econometrica, is a landmark in the annals of the social sciences. The paper presents a direct challenge to standard expected utility theory through the concept of loss aversion, describing how economic agents assess prospective losses and gains in an asymmetric manner. In other words, people frame transactions or outcomes in their minds subjectively, affecting the value (or utility) they expect to receive.

...

"Though Kahneman himself had expressed it in various ways over the years, he put it crisply in 2016:

"CASBS is where behavioral economics took shape. When Richard Thaler heard that Amos Tversky and I would be in Stanford, he finagled a visiting appointment down the hill to spend time with us. We spent a lot of time walking around the Center and became lifelong friends. Those long conversations that Dick had with Amos and me helped him construct his then heretical (and now well-established) view of economics, by using psychological observations to explain violations of standard economic theory.[5]

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Earlier:

Wednesday, March 27, 2024

Danny Kahneman (1934-2024)

Nobel prize medals at auction---two for chemistry (1996 and 1966)

 For charity, to clean up estates of the departed, and for other reasons, Nobel prize medals are sometimes sold at auction.  Here are two recent auctions (conducted in March and July of this year)  for chemistry medals from 1996 (for Robert Curl) and 1966 (for Robert Mulliken), both conducted by the Nate D. Sanders auction company.

Lot #1: Nobel Prize in Chemistry Awarded to Robert F. Curl, Jr. -- Curl Discovered ''Buckyballs'', a Carbon Nanoparticle Transforming Energy, Disease Treatment & Space Exploration via Space Elevators

Lot #11: Nobel Prize Awarded to ''Mr. Molecule'' Robert S. Mulliken -- Mulliken Invented Molecular Orbital Theory, the Revolutionary Equation that Unified Quantum Physics & Chemistry

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Some earlier auctions:

Wednesday, June 22, 2022

Russian Journalist’s Nobel Medal Sells for $103.5 Million, with proceeds to UNICEF for Ukrainian refugees.

Saturday, October 26, 2019

Auction results: Nobel medals of John Nash and Reinhard Selten

Saturday, September 3, 2016

Sotheby's to Offer John F. Nash, Jr.'s 1994 Nobel Memorial Prize in Economic Sciences

Tuesday, October 11, 2016 John F. Nash, Jr.'s 1994 Nobel Prize in Economic Sciences medal and memorabilia: Auction at Sotheby's

Sunday, April 28, 2019 Hayek at auction at Sothebys

Thursday, October 27, 2016 Re-auction of Kenneth Wilson's, 1982 Nobel medal for Physics

Thursday, February 26, 2015 Kuznets' Nobel Prize medal auction

Tuesday, March 5, 2013 Nobel medal and diploma of Francis Crick: available at auction

Tuesday, April 23, 2013 Crick's Nobel medal, and letter to his son describing DNA

Thursday, May 28, 2015   The auction of Lederman's Nobel medal goes into extended bidding

Chicago celebrates Phil Reny

Economic Theory Conference Honoring Phil Reny, organized by Benjamin Brooks, Vasiliki Skreta and Kai Hao Yang

"The Becker Friedman Institute for Economics and the Kenneth C. Griffin Department of Economics will host a conference on Economic Theory celebrating our friend and colleague Phil Reny. The Economic Theory Conference Honoring Phil Reny will be held September 20-21, 2024, at the University of Chicago. This conference will feature presentations by Phil’s colleagues, coauthors, and students."

 Phil Reny is the The Hugo F. Sonnenschein Distinguished Service Professor in Economics and the College

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Earlier

Monday, July 25, 2022

Efficient school choice when schools are not players: Phil Reny in the AER

An Experimental Study of the Chinese Organ Allocation System

 China presently has a low rate of organ donations per million population, so there's a lot of room for growth.  Here's a study suggesting that giving priority on the waiting list to family members of donors could help (as it has done in Israel):

Li, Danyang, Luo, Jun, Ye, Hang and Zheng, Heng. "Is Family-Priority Rule the Right Path? An Experimental Study of the Chinese Organ Allocation System" The B.E. Journal of Economic Analysis & Policy, vol. 24, no. 3, 2024, pp. 929-964. https://doi-org.stanford.idm.oclc.org/10.1515/bejeap-2023-0213

Abstract: China is experiencing an organ shortage crisis. We experimentally test the effectiveness of the family-priority allocation rule on organ donation and argue that such incentive would be highly motivating in Chinese family-oriented culture. Results of our experiment show that introducing the family-priority rule can not only increase donor registration but also promote family consent. Such priority rule would be particularly effective to increase deceased organ donation in China, as it will significantly promote donor registration and meanwhile generate a consistent higher family consent rate in a more family-orientated culture.

Performance Feedback and Organ Donor Registrations, by House, Lacetera, Macis, and Mazar.

 When you register for a driver's license in the U.S., you fill out a form that has an opportunity to register as an organ donor. Did the clerk who accepts your form ask you if you had checked the box?  Would it help if he/she got feedback on how many organ donor registrations she had facilitated?

Here's an experiment about the equivalent interaction in Canada, where "most of the organ donor registrations in Ontario (pre-Covid-19 pandemic: 85 %) occurred during in-person visits to ServiceOntario centers (Trillium Gift of Life, 2017), which through their customer service representatives (CSRs) provide a wide range of services to residents ranging from issuing driver and vehicle licensing to public health insurance registration and business licensing."

House, Julian, Nicola Lacetera, Mario Macis, and Nina Mazar. "Nudging the Nudger: Performance Feedback and Organ Donor Registrations." Journal of Health Economics (2024): 102914.

"Abstract: In a randomized controlled trial conducted in three waves over 2.5 years and involving nearly 700 customer-service representatives (CSRs) from a Canadian government service agency, we studied how providing CSRs with repeated performance feedback, with or without peer comparison, affected their subsequent organ donor registration rates. The feedback resulted in a 25 % increase in daily signups compared to otherwise equivalent encouragements and reminders. Adding benchmark information about peer performance did not amplify or diminish this effect. We observed increased registration rates for both high and low performers. A post-intervention survey indicates that CSRs in all conditions found the information included in the treatments helpful and motivating, and that signing up organ donors makes their job more meaningful. We also found suggestive evidence that performance feedback with benchmark information was the most motivating and created the least pressure to perform."

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Related post:

Monday, July 22, 2024

Don't take "No" for an answer in deceased organ donor registration (a paper forthcoming after ten+ years)

Knights and Knaves reimagined by Jacob Glazer and Ariel Rubinstein

 Knights and Knaves are a venerable class of logical puzzles in which knights always tell the truth and knaves always lie, and the task is to think of a way to interrogate a knight or knave to learn the truth about something.  Here's a paper by Glazer and Rubinstein that looks like it opens a new vista of such problems (but don't trust me, I could be a knave...)

Magical Implementation by Jacob Glazer and Ariel Rubinstein, July 21, 2024

"Abstract: A principal would like to decide which of two parties deserves a prize. Each party privately observes the state of nature that determines which of them deserves the prize. The principal presents each party with a text that truthfully describes the conditions for deserving the prize and asks each of them what the state of nature is. The parties can cheat but the principal knows their cheating procedure. The principal “magically implements” his goal if he can come up with a pair of texts satisfying that in any dispute, he will recognize the cheater by applying the “honest-cheater asymmetry principle”. According to this principle, the truth is with the party satisfying that if his statement is true, then the other party (using the given cheating procedure) could have cheated and made the statement he is making, but not the other way around. Examples are presented to illustrate the concept."

Before getting technical, the paper begins with this delightful example.

"Two invigilators, A and B, have witnessed a student receiving a whispered message from another student during an exam. The invigilators have not seen the questions on the exam but would be able to solve them. It is known that A does not like the student who received the message while B does. The exam includes multiple questions but only one refers to the variable α and reads as follows: “Solve the equation α + 1 = 4.” The student answers the question correctly. Invigilator A claims that the whispered message was: “α = 3.” This is a serious allegation and if correct, the student’s exam will be disqualified. Invigilator B claims that the whispered message was: “Solve the equation α+1 = 4 first.” If he is right, then the student’s answer genuinely reflects his knowledge of the material and there will not be any serious consequences. Who should be believed: A or B?

"Although there is no definitive proof one way or the other, we would choose to believe B. The reasoning would be that if the message was “Solve the equation α + 1 = 4 first”, then A (who dislikes the student) could solve the equation himself and claim that the message was “α = 3”. On the other hand, if the message was “α = 3” it is very unlikely that B (who likes the student and who, as mentioned, has not seen the exam questions) could guess that the equation to be solved is α+1 = 4 rather than any other equation with the same solution. Hence, there is an asymmetry between the two conflicting claims which makes it possible to reasonably conclude that B’s claim is the truthful one."

The End Kidneys Death Act has growing support

I've earlier blogged about the Coalition to Modify NOTA (the National Organ Transplant Act of 1984).

Here is a summary of their proposed legislation

The End Kidney Deaths Act Summary

It begins this way:

"The End Kidney Deaths Act is a ten year pilot program to provide a refundable tax credit of $10,000 each year for five years ($50,000 total) to living kidney donors who donate a kidney to a stranger, which will go to those who have been waiting longest on the kidney waitlist. By the 10th year after the passage of the End Kidney Deaths Act, up to 100,000 Americans who were dying on the waitlist will instead have healthy kidneys, and taxpayers will have saved $10-$37 billion. Deceased donor kidneys last half as long as living donor kidneys, the gold standard of kidney care.

"One author of the National Organ Transplant Act, Representative Al Gore, said 40 years ago in 1984 that if transplant centers conclude efforts to improve voluntary donation are unsuccessful, incentives including tax credits, should be provided to donors."  

Their list of supporters is growing, and includes many transplant professionals as well as many people who have already donated or received kidneys.

Redesigning academia

 Here's an article that presents for discussion possible market design changes in academic earth sciences.  Some of them don't apply immediately to Economics (e.g. we already admit grad students to departments without assigning them to specific advisors and grants), but others refer to much broader practices.

Kemeny, P.C., Phillips, A.A. and Johnson, D.L., 2024. Replaying the tape of academia: Fourteen alternative practices for the physical sciences. Perspectives of Earth and Space Scientists, 5(1), p.e2024CN000240. 

Don't take "No" for an answer in deceased organ donor registration (a paper forthcoming after ten+ years)

 Here's a paper reporting a "field in the lab" experiment with actual organ donor registrations, that took over ten years to get published (after considerable revision and additional data collection).  But it has an important message for how to ask people to agree to donate their organs after they die, should they happen to be among those rare cases in which deceased organs can be donated.  The paper has two messages: one is that it doesn't increase donor registration to ask people to answer 'yes' or 'no', compared to just asking if they want to register at this time.  The second message is that people who have declined to register as a donor in the past may agree if asked again (so, don't take "no" for a final answer).

Here's the pre-publication version that will appear in AEJ:Policy.

Increasing Organ Donor Registration as a Means to Increase Transplantation: An Experiment With Actual Organ Donor Registrations  by Judd B. Kessler and Alvin E. Roth, AMERICAN ECONOMIC JOURNAL: ECONOMIC POLICY (FORTHCOMING)

Abstract: The U.S. has a severe shortage of organs for transplant. Recently — inspired by research based on hypothetical choices — jurisdictions have tried to increase organ donor registrations by changing how the registration question is asked. We evaluate these changes with a novel “field-in-the-lab” experiment, in which subjects change their real organ donor status, and with new donor registration data collected from U.S. states. A “yes/no” frame is not more effective than an “opt-in” frame, contradicting conclusions based on hypothetical choices, but other question wording can matter and asking individuals to reconsider their donor status increases registrations.

And here's the blog post about and link to the 2014 NBER working paper (which was itself a revision of an earlier version), and some of the press coverage it received at the time:

Tuesday, September 2, 2014

Don't take "No" for an answer: a reconsideration of how to do deceased donor registration

Signaling for medical residencies: the first few years

Two papers report on signaling in Otolaryngology and Orthopaedic surgery.

 The Otolaryngology societies have a summary of the current state of affairs that's worth hearing. A number of specialties (including Oto) allow many signals, and these seem to be acting as a soft cap on applications, rather than as a signal of special interest as in specialties that (like Economics) allow only a small number of signals.

Preference Signaling in Otolaryngology—Past, Present, and Future: A Comment From the Society of University Otolaryngologists (SUO), Association of Academic Departments in Otolaryngology (AADO), and the Otolaryngology Program Directors Organization (OPDO)  by Steven D. Pletcher MD, Bradley F. Marple MD, David J. Brown MD, The Laryngoscope Early View,  First published: 04 July 2024  https://doi.org/10.1002/lary.31613

"The year 2020 was a year of change. The residency application process, already suffering from spiraling application numbers,1 now faced the COVID-19 pandemic with a loss of away rotations and apprehension about virtual interviews. In the face of change, the Otolaryngology Program Directors Organization Council (OPDO) approached the leadership of the Association of Academic Departments in Otolaryngology (AADO) and the Society of University Otolaryngologists (SUO) with a recommendation to implement preference signaling. This system, originally described in the economics PhD marketplace,2 allows students a set number of signals (Otolaryngology used 5 in its inaugural year) to send to programs of particular interest. 

...

"Following the lead of Otolaryngology, Urology, General Surgery, Internal Medicine, and Dermatology implemented preference signaling the following year. Since that time, signaling has grown exponentially and is now utilized in the residency application process of nearly every specialty. 

...

"In the 2024-2025 residency application cycle, the evolution of preference signaling continues. Building on Otolaryngology's experience, in the 2023 application cycle Orthopaedic Surgery implemented a high-signal approach, providing applicants with 30 signals. This transition shows promise for reversing the vexing problem of spiraling application numbers—“Big Signaling” has now been adopted by Otolaryngology and four additional specialties the majority of whom have shown a 25%–30% decrease in applications submitted per student saving students a combined $2.5 million in application fees alone. Obstetrics and Gynecology has piloted a tiered signaling system, providing three gold and 15 silver signals to their students. 

...

"Because the number of signals received by programs is not publicized, students are unable to reliably target programs where their signals are less likely to be diluted by competing signals. Specialties should consider providing voluntary “signal cohort” (i.e., my program received between 75 and 100 signals in the 2024 application cycle) data to help applicants make more informed signal decisions and programs with low signal numbers will likely attract additional candidates. 

...

"One of the key statistics to guide applicants in high signal specialties is the interview offer rate for non-signal applications: this helps define the value of applications beyond the set number of signals."

########

Preference Signaling in the Orthopaedic Surgery Match: Applicant and Residency Program Attitudes, Behaviors, and Outcomes, by Guthrie, Stuart Trent MD, FAOA1,a; Dagher, Tanios BSE2; Essey-Stapleton, Jodi MS, MEd3; Balach, Tessa MD, FAOA2,  JBJS Open Access 9(2):e23.00146, April-June 2024. | DOI: 10.2106/JBJS.OA.23.00146

"In the first year of preference signaling, applicants reported applying to 16% fewer programs than if preference signaling had not been available. These results align with AAMC data, which report applications per program dropping 17.4% (from an average of 639.6 to 774.6), and applications per applicant dropping to 76.9 from 86.07,8. Further changes could occur in future cycles as students become more accustomed to the influence of signaling on their application."

Black markets in everything bagels (in S. Korea)

 South Korea is not a hub of everything bagels, it turns out. In fact they are banned.

The NYT has the story:

Why Everything Bagel Seasoning Was Banned in South Korea. The seasoning is sold by Trader Joe’s, a brand whose popularity has skyrocketed in the region in recent years.By Eve Sampson

"Food containing poppy seeds, “including popular bagel seasoning blends,” is considered contraband in South Korea, according to the U.S. Embassy, making the coveted topping a forbidden treat.

...

"As more travelers have tried to bring the popular seasoning mix into South Korea, local news and social media sites have reported in recent weeks on an increase in confiscations at airports.

"Poppy seeds are not opiates but may be contaminated by the plant’s fluid, which contains opiates, when they are harvested. 

...

"In South Korea, poppy seeds are banned because they are considered a narcotic.

...

"South Korea is among the few countries with laws regulating poppy seeds. The United Arab Emirates bans the seed, and Singapore requires anyone wishing to import poppy seeds to submit a sample for opiate testing.

"In the United States, there has also been mixed messaging about poppy seeds. In 2023, the Department of Defense warned members of the military that eating poppy seeds could result in a positive drug test, despite the military previously feeding service members poppy seed breads in ready-to-eat meals."