Freezing (and then carefully warming) donor organs breaks the organ transplant time barrier (for rats, for the time being)

 Here's a note in Nature Reviews Nephrology pointing out the longer term promise of the recent successful freezing, thawing, and transplantation of rat kidneys.

Cryopreservation breaks the organ transplant time barrier by Marlon J. A. de Haan & Ton J. Rabelink, in Nature Reviews Nephrology (2023)

"The pressing issue of organ shortages for transplantation is fuelled by the rising incidence of kidney failure and the declining quality of organs from an ageing donor pool. However, the main bottleneck in organ transplantation is time; indeed, the current clinical standard for kidney preservation necessitates immediate transplantation following organ recovery1. This urgency often results in suboptimal matches between donors and recipients. Cryopreservation has emerged as a potential solution to this challenge. Such an approach would enable organs to be preserved in a suspended state for extended periods and ready for transplantation on demand. The prospect of long-term banking of cryopreserved organs holds promise for transforming organ transplantation into an elective procedure, thereby enhancing donor–recipient matching, improving equity in access, optimizing patient preparation, refining transplant tolerance protocols, increasing organ utilization and improving graft and patient survival. However, even though cryopreservation has successfully been used to store human embryos, extending the process to preserve whole organs has remained a scientific aspiration — until now. A study by Han et al. introduces an approach to cryopreservation that seemingly extends the shelf life of organs indefinitely2."

...

"By rapidly cooling rat kidneys to –150°C, Han et al. were able to halt the biological clock of the organs, effectively inducing a glass-like state — a process known as vitrification2 (Fig. 1). Specifically, the researchers perfused a cocktail of cryoprotective agents (CPAs) and iron oxide nanoparticles into the organ’s vasculature, which they followed by rapid cooling to ultralow temperatures to achieve a state of vitrification. This vitrified kidney, with its hard, smooth, glasslike appearance, was then transferred to a –150°C freezer for long-term banking. When these kidneys were later rewarmed and transplanted into nephrectomized recipients, they regained life-sustaining renal function. The rewarming stage poses more challenges to the process of cryopreservation: it requires both speed to avoid ice formation during devitrification and uniformity to prevent thermal stresses and mechanical cracks. Here, the iron oxide nanoparticles had a crucial role. Placing the vitrified kidney in a coil that generates electromagnetic fields activates these nanoparticles, generating heat. This innovative approach enabled rapid rewarming at an impressive rate of approximately 72 °C per minute throughout the entire organ, ensuring uniform warming rather than limiting warming to the organs’ surface. This ground-breaking milestone marks an extraordinary achievement in ‘reviving’ a complex organ like the kidney and is the culmination of decades of research into methods to prevent the destructive formation of ice during the cooling process, minimize toxicity from CPAs, and enable fast and uniform rewarming3.

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Recently:

Wednesday, June 28, 2023

Freezing, thawing and transplanting a rat kidney: a first step towards organ banking

Homelessness and fentanyl, in Oregon and California

 Both the criminal justice system and the harm reduction movement seem to be facing an intractable problem with fentanyl and homelessness.  (We lost the war on drugs, but surrender isn't working either.)

Here are two NYT stories, from Oregon and California.

The Struggle to Save Portland, Oregon. The city has long grappled with street homelessness and a shortage of housing. Now fentanyl has turned a perennial problem into a deadly crisis and a challenge to the city’s progressive identity.  By Michael Corkery

"This city of 635,000 ...  has long grappled with homelessness. But during the pandemic this perennial problem turned into an especially desperate and sometimes deadly crisis that is dividing Portland over how to fix it.

...

"In 2022, Portland experienced a spate of homicides and other violence involving homeless victims that rattled many in the community.

...

"The search for answers points in many directions — to city and county officials who allowed tents on the streets because the government had little to offer in the way of housing, to Oregon voters who backed decriminalizing hard drugs and to the unrest that rocked Portland in 2020 and left raw scars.

"But what has turbocharged the city’s troubles in recent years is fentanyl, the deadly synthetic drug, which has transformed long standing problems into a profound test of the Portland ethos.

"Outreach workers in Portland say rampant fentanyl use has coincided with the increasing turmoil among many homeless residents.

"Doctors who care for people living on the streets say fentanyl addiction is proving harder to treat than many other dependencies."

***********

Homeless Camps Are Being Cleared in California. What Happens Next? One of the state’s largest homeless encampments was recently shut down in Oakland, but that didn’t stop the problem of homelessness.  By Livia Albeck-Ripka

"The evictions have brought into sharp relief one of the most intractable challenges for American cities, particularly those in California. As homelessness has surged, more people have congregated in large encampments for some semblance of security and stability. But such sites are often unsanitary and dangerous, exhausting neighbors and the owners of nearby businesses.

"What happens after the closure of Wood Street and other camps in California will serve as the latest test of how effectively the state is addressing homelessness. Nearly half of the nation’s unsheltered population — those who sleep on the streets, in tents, in cars or in other places not intended for human habitation — resides in California, according to last year’s federal tally of homelessness. The state makes up about 12 percent of the country’s overall population.

"In California, Democratic leaders who previously tolerated homeless camps have lost their patience for the tent villages and blocks of trailers that proliferated during the pandemic.

"Governor Newsom has helped clear homeless camps himself and has told mayors he was trying to set an example. San Diego recently banned encampments on public property. And Karen Bass, the mayor of Los Angeles, has moved more than 14,000 homeless people into temporary housing since taking office in December, her office said last month.

...

"Community cabins and safe camping sites usually provide only temporary shelter, falling short of the permanent housing that is considered ideal. But they seem to be the best that California can do, with a severe housing shortage and high costs. Despite the state’s spending of more than $30 billion since 2019 on housing-related programs, the homeless population there has continued to grow.

“This is a very difficult population to serve, with very complex needs. And if we can bring someone inside even for a little bit, that’s a victory for that person,” said Jason Elliott, the deputy chief of staff for Governor Newsom. “We may not have permanent housing stick the first time, or the fourth time or the fifth time, but we’re going to keep trying.”

"According to a September audit of Oakland’s homelessness services, close to half of the people housed in community cabins ended up back on the street in the 2020-21 fiscal year."

***********

Earlier:

Friday, July 14, 2023

Harm reduction is not a panacea: drug use and drug policy in Portugal, and San Francisco

Compensating kidney donors: a call to action by Brooks and Cavanaugh in the LA Times

 Here's a clarion call for compensation of living kidney donors, from two nondirected kidney donors.  It's not the first, and very likely not the last, given the difficulty of modifying the existing law.  But it makes the case very clearly (and proposes that a tax credit spread over ten years might be the way to move foreward).

Opinion: A single reform that could save 100,000 lives immediately BY NED BROOKS AND ML CAVANAUGH, JULY 9, 2023 

"Never in the field of public legislation has so much been lost by so many to one law, as Churchill might’ve put it. The National Organ Transplant Act of 1984 created the framework for the organ transplant system in the United States, and nearly 40 years later, the law is responsible for millions of needless deaths and trillions of wasted dollars. The Transplant Act requires modification, immediately.

"We’ve got skin in this game. We both donated our kidneys to strangers. Ned donated to someone who turned out to be a young mother of two children in 2015, which started a chain that helped an additional two recipients. And Matt donated at Walter Reed in 2021, after which his kidney went to a Seattleite, kicking off a chain that helped seven more recipients, the last of whom was back at Walter Reed.

"Ned founded, and Matt now leads, an organization that represents nearly 1,000 living donors

...

"eight years ago, when Ned donated, the number of living kidney donors was 6,000. With all the work we’ve done since, the number of living donors is still about 6,000 annually. In the United States, nearly 786,000 people suffer from end-stage kidney disease, more people than can fit in the 10 largest NFL stadiums combined.

...

"More Americans die of kidney disease than of breast or prostate cancer, and one in three of us is at risk. This illness is widespread, but what makes it worse is the staggering financial burden borne by everyone. The head of the National Kidney Foundation testified in March that Medicare spends an estimated $136 billion, nearly 25% of its expenditures, on the care of people with a kidney disease. Of that, $50 billion is spent on people with end-stage kidney disease, on par with the entire U.S. Marine Corps budget.

...

"The National Organ Transplant Act prohibits compensating kidney donors, which is strange in that in American society, it’s common to pay for plasma, bone marrow, hair, sperm, eggs and even surrogate pregnancies. We already pay to create and sustain life

...

"The ethical concerns regarding compensation are straightforward. Nobody wants to coerce or compel those in desperate financial straits to do something they would not have done otherwise. The challenge, then — until artificial or nonhuman animal substitutes are viable options — is to devise a compensation model that doesn’t exploit donors.

"Compensation models have been proposed in the past. A National Institutes of Health study listed some of the possibilities, including direct payment, indirect payment, “in kind” payment (free health insurance, for example) or expanded reimbursements. After much review, we come down strongly in support of indirect payment, specifically, a $100,000 refundable federal tax credit. The tax credit would be uniformly applied over a period of 10 years, in the amount of $10,000 a year for those who qualify and then become donors.

"This kind of compensation is certainly not a quick-cash scheme that would incentivize an act of desperation. Nor does it commoditize human body parts. Going forward, kidney donation might become partly opportunistic rather than mostly altruistic, as it is now. But would it be exploitative? Not at all."

...

Ned Brooks and ML Cavanaugh are living kidney donors, and Brooks is the founder of the Coalition to Modify NOTA.

********

Here are all my posts that mention Ned Brooks, starting with this one:

Friday, February 26, 2016

A Freakonomics listener was inspired to become a non-directed kidney donor by the podcast on kidney exchange

Cryopreservation of organs for transplants, and Sebastian Giwa in Forbes

 Forbes has a long, interesting, somewhat breathless story about the progress and promise of freezing organs for transplants, including not only the usual eight organs, but also bone marrow/blood stem cells. It focuses on one of the entrepreneurs in the field, Dr. Sebastian (Seb) Giwa, and his colleague Jedd Lewis among others

New Breakthroughs In Cryopreservation Poised To Transform Organ Transplantation, by Alex Zhavoronkov, PhD, Jul 5, 2023

"To understand how this came about I delved into the career of the founder and CEO of Sylvatica Biotech, Dr. Sebastian Giwa (called “Seb” by his friends). Seb is credited by many as the chief architect of the surge of scientific interest in cryopreservation over the last several years.

Sebastian Giwa, PhD, MBA 

BRIDGET BENNETT

...

"Trying to donate organs (without cryopreservation) is a lot like trying to donate perishable (non-canned) food: there are certainly a lot of starving people in the world, but good luck finding a recipient for every single ounce before it expires. 

...

"[Organ Preservation Alliance]  partnered ... to publish position papers, including a peer-reviewed article in Nature Biotechnology outlining the need for an organ cryopreservation research effort. The paper was co-authored with all of the major U.S. transplant societies and a star-studded lineup of scientists including Robert Langer, George Church, and Ed Boyden, and even Nobel Prize-winning economist Alvin Roth – whose work has focused on finding new ways to ameliorate the organ shortage. It is currently in the top 1% of the most widely read scientific articles published since its release.

...

"Donor bone marrow is lifesaving for many kinds of  cancers and a variety of other blood diseases. Successful bone marrow transplants have been performed since the 1950s, but the challenge is finding a source of bone marrow to transplant – especially since donors and recipients must be matched for genetic factors even more precisely than some organ transplants.

...

" if bone marrow could be cryogenically banked, why not procure it from deceased organ donors who were already providing hearts, livers, and other organs for transplantation? There are nearly 40,000 such donors worldwide each year, and each could potentially donate enough marrow for multiple patients in need. For many patients, when a transplant was needed the matching bone marrow would already be available in the bone marrow bank.

"From the perspective of the deceased organ donor and the OPOs, this would be like providing an opportunity to donate an additional lifesaving organ. Traditionally, each donor can provide up to eight lifesaving vital organs: a heart, two lungs, two kidneys, a liver, intestines, and a pancreas. In essence, bone marrow would be the ninth. And if a donor could provide bone marrow to multiple recipients, this might even double the number of lives that each donor could save.

...

"Alex: What’s something we haven’t covered that excites you about what cryopreservation can do for the organ shortage?

"Seb: In the long-term, one of the things that I’m most excited about is how these technologies can remove barriers to developing transplant systems in new countries. Most of the world still doesn’t have access to deceased donor transplantation. For instance, Africa has 16% of the world’s population but only 0.5% of transplants are done there. Meanwhile the U.S. has less than 5% of the world’s population but does about 25% of the world’s transplants. Many developed countries, like my father’s home country Ghana, have limited live kidney donation programs. But they don’t have deceased donor programs, which are needed to carry out large numbers of kidney and liver transplants as well as any sort of heart or lung transplantation.

"That’s partly because the logistical demands to source organ donations prospectively require so much infrastructure: a waitlist, rapid matching of donors to recipients, OPOs that need to be overstaffed in order to deal with unpredictable surges in organs available, rushed activities that require tight coordination between donor hospitals, OPOs, transplant centers, and even third party service providers like organ couriers. Many organs have also needed expensive transportation (private jets and helicopters).

"It’s a very different situation when there’s a source of cryopreserved hearts, livers, etc., that can be donated in a much more flexible way and are simply waiting to be matched to patients. Even things like Doctors without Borders and perhaps “OPOs without Borders” become possible for transplantation, helping train and develop new organ recovery, heart, lung, and liver transplant programs. So many more possibilities open up when you don’t need to create every part of a transplant system from scratch and have all of those parts acting in synchrony on Day 1."

**************

Here's the original article referred to:

The promise of organ and tissue preservation to transform medicine 
 Sebastian Giwa, Jedediah K Lewis, Luis Alvarez, Robert Langer, Alvin E Roth, George M Church, James F Markmann, David H Sachs, Anil Chandraker, Jason A Wertheim, Martine Rothblatt, Edward S Boyden, Elling Eidbo, W P Andrew Lee, Bohdan Pomahac, Gerald Brandacher, David M Weinstock, Gloria Elliott, David Nelson, Jason P Acker, Korkut Uygun, Boris Schmalz, Brad P Weegman, Alessandro Tocchio, Greg M Fahy, Kenneth B Storey, Boris Rubinsky, John Bischof, Janet A W Elliott, Teresa K Woodruff, G John Morris, Utkan Demirci, Kelvin G M Brockbank, Erik J Woods, Robert N Ben, John G Baust, Dayong Gao, Barry Fuller, Yoed Rabin, David C Kravitz, Michael J Taylor & Mehmet Toner

Nature Biotechnology 35, 530–542 (2017) doi:10.1038/nbt.3889
Published online 07 June 2017

Abstract: The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science.

************

Here's a recent related post:

Wednesday, June 28, 2023

Freezing, thawing and transplanting a rat kidney: a first step towards organ banking

Market shaping ideas sought at U. Chicago

 The Market Shaping Accelerator at the University of Chicago is seeking to find innovative proposals: MSA Innovation Challenge 2023

"MSA’s inaugural Innovation Challenge 2023 will award up to $2,000,000 in total prizes for ideas that identify areas where a pull mechanism would help spur innovation in biosecurity, pandemic preparedness, and climate change, and for teams to design that incentive mechanism from ideation to contract signing.

...

"Pull mechanisms are policy tools that create incentives for private sector entities to invest in research and development (R&D) and bring solutions to market. Whereas “push” funding pays for inputs (e.g. research grants), “pull” funding pays for outputs and outcomes (i.e. prizes and milestone contracts). These mechanisms “pull” innovation by creating a demand for a specific product or service, which drives private sector investment and efforts towards developing and delivering that product or technological solution.

"One example of a pull mechanism is an Advance Market Commitment (AMC), which is a type of contract where a buyer, such as a government or philanthropic organization, commits to purchasing (or subsidizing) a product or service at a certain price and quantity once it becomes available. This commitment creates a market for the product or service, providing a financial incentive for innovators to invest in R&D and develop solutions to meet that demand.

"An AMC was used in the early 2000s in the case of developing a pneumococcal vaccine for the strain of the virus affecting children in low and middle income countries. Another current example is Frontier, led by Stripe, which is an AMC to accelerate carbon removal.

"In general, pull mechanisms are useful when we know we need an innovation, but we don’t who is best placed to develop it or how."

************

Earlier:

Friday, May 12, 2023

Market Shaping at the University of Chicago: Promoting needed innovation

Challenge trial for Covid in England reveals airborne superspreaders

 Nature has a news story about a Lancet Microbe paper reporting the challenge trial. See links to and excerpts from both below.

Here's the Nature story:

What makes a COVID superspreader? Scientists learn more after deliberately infecting volunteers. A rigorous study identifies ‘supershedders’ who spew huge amounts of virus into the air — despite having only mild symptoms. by Saima Sidik

"A study of people who were intentionally infected with SARS-CoV-2 has provided a wealth of insights into viral transmission — showing, for example, that a select group of people are ‘supershedders’ who spew vastly more virus into the air than do others1.

"The publication describes data from a controversial ‘challenge study’, in which scientists deliberately infected volunteers with the virus that causes COVID-192. Although the approach drew opposition, the work has now yielded data on questions central to public health, such as whether the severity of symptoms correlates with how contagious people are and whether home COVID-19 tests can play a part in reducing viral spread.

...

"Challenge studies are “very bold”, says Gandhi. Some people argue that it’s unethical to give people an infection that can cause severe illness, but the research design comes with benefits. Challenge studies can substantially speed up vaccine testing, and they’re the only way to understand certain aspects of COVID-19, such as the stage before people test positive or develop symptoms.

"Researchers inoculated 34 healthy young participants by squirting a known quantity of viral particles up their noses. Eighteen developed infections and spent at least 14 days confined to hospital rooms. Each day, researchers measured viral levels in the participants’ noses and throats, in the air, and on the participants’ hands and various surfaces in the rooms.

...

"Of the 18 participants who developed infections, 2 shed 86% of the airborne virus detected over the course of the entire study — even though both had only mild symptoms. Previous research3 has provided evidence for the existence of superspreaders who infect large numbers of people. But whether such people are also ‘supershedders’ who emit copious amounts of virus, or simply have many social contacts, was up for debate

..

"None of the participants emitted a detectable level of virus into the air before testing positive, and only a small proportion of them left detectable virus on their hands, on surfaces or on masks that they donned temporarily.

"By the time they tested positive, most participants had already experienced mild symptoms, such as tiredness or muscle aches. That means that if people test as soon as they detect symptoms, rapid tests “can be a powerful tool” for controlling viral spread, says infectious-disease researcher Christopher Brooke at the University of Illinois at Urbana-Champaign.

***********

And here's the original paper:

Jie Zhou, Anika Singanayagam, Niluka Goonawardane, Maya Moshe, Fiachra P Sweeney, Ksenia Sukhova, Ben Killingley, Mariya Kalinova, Alex J Mann, Andrew P Catchpole, Michael R Barer, Neil M Ferguson, Christopher Chiu, Wendy S Barclay, Viral emissions into the air and environment after SARS-CoV-2 human challenge: a phase 1, open label, first-in-human study, The Lancet Microbe, 2023, ISSN 2666-5247, https://doi.org/10.1016/S2666-5247(23)00101-5. (https://www.sciencedirect.com/science/article/pii/S2666524723001015)

"After controlled experimental inoculation, the timing, extent, and routes of viral emissions was heterogeneous. We observed that a minority of participants were high airborne virus emitters, giving support to the notion of superspreading individuals or events. Our data implicates the nose as the most important source of emissions. Frequent self-testing coupled with isolation upon awareness of first symptoms could reduce onward transmissions."

Guns and gun control

 In the U.S., gun sales are both a protected transaction and a repugnant one. The right to bear arms is protected by the 2nd Amendment to the Constitution, but as school shootings and other mass casualty attacks on innocents have become a staple of the news, there have been periodic attempts to curb sales, particularly of automatic weapons.  The state of Washington is the latest to ban the sale of certain particular automatic weapons, which are legally available in other states, and already very widely distributed.

The NYT has the story:

Selling AR-15-Style Rifles Is Now Banned in 9 States  By Mike Baker and Nicholas Bogel-Burroughs

"Washington State approved a package of gun control measures on Tuesday that includes a ban on the sale of military-style semiautomatic weapons, making it the ninth state to join efforts to prevent the distribution of AR-15s and other powerful rifles often used in mass shootings.

"The new laws put Washington in the ranks of states with the strongest gun control measures in the nation. They include a 10-day waiting period on gun purchases, gun safety training requirements and a provision allowing the state attorney general and consumers to sue gun manufacturers or dealers under public nuisance laws if they negligently allow their guns to fall into the hands of minors or “dangerous individuals.”

"Gun rights proponents swiftly filed a lawsuit to challenge the semiautomatic rifle ban, saying it infringed on Second Amendment rights.

"Washington is among a series of states, largely led by Democrats, that have advanced gun legislation this year as the nation continues to grapple with repeated mass shootings. Republicans have moved in the opposite direction, with lawmakers in several states introducing legislation to expand the ability to carry concealed weapons without a permit and eliminate such things as gun-free zones, background checks and red-flag laws, which allow the removal of guns from people deemed to be at high risk of violence or self-harm.

...

"All of the bans currently in place allow people to keep weapons previously purchased, but states vary on how those so-called legacy weapons are regulated, according to the Giffords Law Center to Prevent Gun Violence."

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Earlier:

Sunday, April 16, 2023

The (American) market for assault rifles

Transplantation: progress and continued shortcomings

 Here's a guest essay from the NYT that focuses on a different set of shortcomings of organ transplantation than organ availability. The author writes about how her long history of immunosuppression, to keep her transplanted organ(s) alive, has left her vulnerable to cancer.

My Transplanted Heart and I Will Die Soon.  By Marine Buffard

"My 35 years living with two different donor hearts (I was 25 at the time of the first transplant) — finishing law school, getting married, becoming a mother and writing two books — has felt like a quest to outlast a limited life expectancy. 

...

"Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors. And I understand the irony of an incredibly successful and fortunate two-time heart transplant recipient making this case, but my longevity also provides me with a unique vantage point. Standing on the edge of death now, I feel compelled to use my experience in the transplant trenches to illuminate and challenge the status quo.

"Over the last almost four decades a toxic triad of immunosuppressive medicines — calcineurin inhibitors, antimetabolites, steroids — has remained essentially the same with limited exceptions. These transplant drugs (which must be taken once or twice daily for life, since rejection is an ongoing risk and the immune system will always regard a donor organ as a foreign invader) cause secondary diseases and dangerous conditions, including diabetes, uncontrollable high blood pressure, kidney damage and failure, serious infections and cancers. The negative impact on recipients is not offset by effectiveness: the current transplant medicine regimen does not work well over time to protect donor organs from immune attack and destruction.

"My first donor heart died of transplant medicines’ inadequate protection of the donor heart from rejection; my second will die most likely from their stymied immune effects that give free rein to cancer.

...

"Without vigorous pushback, hospitals and physicians have been allowed to set an embarrassingly low bar for achievement. Indeed, the prevailing metric for success as codified by the Health Resources and Services Administration is only one year of post-transplant survival, which relieves pressure for improvement."

*************

That one year of measured graft survival is both too short, as the author points out, and too long.  By penalizing transplant centers for transplants that fail to survive a year, the current regulations make transplant centers too risk averse, so that kidney transplants that would have only, say, an 85% chance of working well are often not conducted, leaving patients to remain on dialysis, often til death,  for that 85% chance of life.

Transplantation is, still, a modern miracle. But until we can do without it, we'll have to keep trying to do it better.

Mega-Journals and scientific publishing

 Academic publishing is getting more varied. A recent article in JAMA focuses on the rise of 'mega-journals,' which seek to publish papers that are correct, without filtering for (referees' opinions about) novelty or importance.

The Rapid Growth of Mega-Journals: Threats and Opportunities  by John P. A. Ioannidis, MD, DSc1,2; Angelo Maria Pezzullo, MD, MSc3; Stefania Boccia, MSc, DSc, PhD3,4, JAMA. Published online March 20, 2023. doi:10.1001/jama.2023.3212

"Mega-journals, those that publish large numbers of articles per year,1 are growing rapidly across science and especially in biomedicine. Although 11 Scopus-indexed journals published more than 2000 biomedical full papers (articles or reviews) in 2015 and accounted for 6% of that year’s literature, in 2022 there were 55 journals publishing more than 2000 full articles, totaling more than 300 000 articles (almost a quarter of the biomedical literature that year). In 2015, 2 biomedical research journals (PLoS One and Scientific Reports) published more than 3500 full articles. In 2022, there were 26 such prolific journals (Table). The accelerating growth of mega-journals creates both threats and opportunities for biomedical science.

...

"we define mega-journals as open-access peer-reviewed journals that charge article processing fees and publish more than 2000 full articles in a calendar year. The 2 early-launched mega-journals, PLoS One and Scientific Reports, were also characterized by very broad publishing scope, covering scientific topics in general. 

...

"Mega-journals typically claim to publish articles based on whether they are scientifically sound rather than important and novel. Accordingly, their acceptance rates, when disclosed, are 20% to 70%

...

"It would be unfair, nevertheless, to dismiss mega-journals as simply a negative development. Several of their characteristics could be aligned also with desirable scientific practices. First, open access is a good starting point, and it can be coupled with greater transparency. If these journals routinely adopt transparent research practices, such as sharing of data, code, protocols, and statistical analysis plans, they can have a transformative effect, given their large output. Several older, broad-scope mega-journals (eg, PLoS One, Royal Society Open Science) have already championed such efforts. It is crucial that disciplinary-focused mega-journals do the same. Second, publishing technically sound scientific work regardless of the nature of the results is highly commendable. It offers opportunities to curb publication and selective reporting bias. Empirical studies are needed to investigate whether mega-journals do achieve this goal or still have selective reporting biases and variants thereof (eg, “spin”). Third, mega-journals may allow publication of results deemed undesirable in traditional specialty journals with entrenched, inbred publishing practices. Enhanced diversity of perspectives and opportunities to challenge orthodoxy are welcome, provided the journals publish rigorous data and safeguard against conflicts of interest. Securing editorial independence and maximizing transparency about conflicts for editors, reviewers, and authors will be key in reaping such benefits.

...

"At the publisher level, competition may have major indirect effects on medicine and science at large. Scientific publishing has an annual work cycle exceeding $30 billion and very large profit margins, which are possible in part because approximately 100 million hours of peer reviewers’ time is offered free yearly.8 The publishers behind the new generation of specialized mega-journals (Table) are taking this money-making recipe to new heights. Science and scientists may feel thwarted, if not entirely powerless, while big publishing corporations fight for field domination. However, it would be to the benefit of all if scientists, medical and research institutions, and funders gave credit to and rewarded journals (and publishers) that promote more transparent research and more rigorous research practices."

Judge shopping for abortion rulings

 Justice (like politics, sausage and econometrics) is constructed in complex ways. The Washington Post has a story on the case against an anti-abortion drug, now being heard by federal judge Matthew Kacsmaryk in Amarillo Texas, which could result in a nationwide ban on that drug.  The case concerns medical issues about drug regulation, and isn't directly concerned with the legal controversy about abortion rights.

The Texas judge who could take down the abortion pill. A devout Christian, Matthew Kacsmaryk has been shaped by his deep antiabortion beliefs. By Caroline Kitchener and  Ann E. Marimow  February 25, 2023 

"The abortion pills lawsuit, which Kacsmaryk could rule on any day, is the latest in a long line of politically explosive cases to appear on the judge’s docket. In a practice known as “forum shopping,” conservative groups have zeroed in on the Amarillo division of the Northern District of Texas as a go-to place to challenge a wide range of Biden administration policies. Because Amarillo is a federal district with a single judge, plaintiffs know their arguments will be heard by Kacsmaryk — who, like any federal judge, is positioned to issue rulings with nationwide implications.

"Appeals from Kacsmaryk’s district follow a path that has regularly yielded favorable outcomes for conservatives — reviewed first by the U.S. Court of Appeals for the 5th Circuit, which upheld a strict Texas abortion ban long before Roe v. Wade was overturned, then ultimately by the conservative-controlled Supreme Court."

********

Here's a related story from Medpage Today:

A Ban on the Abortion Drug Mifepristone Is Looming— A Texas lawsuit may be disastrous for effective abortion access and FDA's authority by Lawrence O. Gostin, JD, LLD, and Sarah Wetter, JD, MPH, February 23, 2023

"In the most consequential and controversial attack on reproductive rights since the overturning of Roe v. Wade, a Texas judge could ban the safest, most effective, and most common method for abortion in all 50 states. The hyper-conservative anti-abortion group Alliance Defending Freedom  (ADF) is seeking to overturn the FDA's approval of mifepristone (Mifeprex), a medication in a two-pill regimen used to terminate pregnancies through the first 10 weeks gestation. The lawsuit does not target the other medication, misoprostol (Cytotec), which FDA approved to treat stomach ulcers, and can be prescribed off-label for abortion.

...

"Given the FDA's rigorous risk evaluation and mitigation strategy (REMS) for mifepristone and its safe use for 23 years, the case is utterly frivolous and political, but due to "judge shopping" the repercussions for reproductive health and equity are real. Perversely, a single federal trial judge has the power to block a federal law, rule, or action on a national scale. The case could make its way to the Supreme Court, with potentially disastrous consequences for safe, effective abortion access and the authority of the FDA."

opens in a new tab or windowfor mifepristone and its safe use for 23 years, the case is utterly frivolous and political, but due to "judge shopping" the repercussions for reproductive health and equity are real. Perversely, a single federal trial judge has the power to block a federal law, rule, or action on a national scale. The case could make its way to the Supreme Court, with potentially disastrous consequences for safe, effective abortion access and the authority of the FDA.

Compensation for participating in clinical trials

 Here's an opinion piece from Medpage Today:

It's Time to Pay Clinical Trial Participants More — Accelerating trial enrollment can catalyze access to much-needed medications  by Gunnar Esiason 

He writes:

"Most people I know with cystic fibrosis have participated in at least one, if not several clinical trials. 

...

"Participating in a trial can be like working for a company that hasn't invested in its employees in a long time. In this case, the employees are clinical trial participants. The pay is low despite the time required to participate in research and the growing number of trials that need participants.

"From 2019-2022, the number of registered clinical trials grew by 25%opens in a new tab or window globally -- yet participant pay remains arbitrary and inconsistentopens in a new tab or window between studies. It's almost like mismatched supply and demand curves, where participants are in high demand but unwilling to participate.

"Increasing trial participant pay might be a path toward alleviating the participant supply crunch in trials hungry for patients. One key benefit of increasing pay for patients could be substantial: namely, speeding up clinical trials through a more competitive enrollment process.

...

"More than 80% of clinical trials fail to enroll on time, leading to costs of anywhere from $600,000 to $8 million per dayopens in a new tab or window and making trials take up to twice as longopens in a new tab or window.

"And yet it has been shownopens in a new tab or window that moderately increasing pay can motivate participation without being an "unjust inducement." In other words, patients are encouraged to participate -- but not coerced to do so.

"If increasing participant pay can accelerate trial enrollment, then a safe and effective drug can reach the market faster and therefore reduce the amount of time products remain in the pre-revenue stage. The return on investment for study sponsors who increase participant pay should be clear from a business perspective.

"From a patient perspective, even a marginal improvement in time to accessing new drugs is something worth celebrating. For patients, we pay the cost of delays with our health."

*********

Some earlier related posts:

Monday, February 22, 2021

Ethical Payment in Human Infection Challenge Studies in the American Journal of Bioethics

Monday, March 1, 2021

Compensating challenge vaccine trial participants: further discussion in the American Journal of Bioethics

Thursday, October 29, 2020

Paying participants in challenge trials of Covid-19 vaccines, by Ambuehl, Ockenfels, and Roth

"we note that increasing hourly pay by a risk-compensation percentage as proposed in the target article provides compensation proportional to risk only if the risk increases proportionally with the number of hours worked. (Some risky tasks take little time; imagine challenge trials to test bulletproof vests.) "

Sunday, November 1, 2020

What do we know about the effects of payments to participants in challenge trials for vaccines, and other public spirited activities?

Obstacles facing liver exchange

 Liver exchange is different than kidney exchange in a number of important dimensions, some of which will present obstacles that need to be overcome in different ways. (Although it looks like in liver exchange the donors will travel to the recipients instead of having the organs shipped, as is now mostly done in U.S. kidney exchange.  That's actually how kidney exchange worked when it began) Here's a recent article from Medscape:

Can a Nationwide Liver Paired Donation Program Work?  by Lucy Hicks

"To expand the number of living liver donations in the United States, the United Network for Organ Sharing (UNOS) has launched the first national paired liver donation pilot program in the United States.

...

"In 2020, 1095 people died while waiting for a liver transplant

...

"Paired kidney donation programs have been running since 2002, but paired liver donation is relatively new. Since the first US living-donor liver transplant in 1989, the procedure has become safer and is a viable alternative to deceased liver donation. A growing number of living donor programs are popping up at transplant centers across the country.

"Still, living-donor liver donation makes up a small percentage of the liver transplants that are performed every year. In 2022, 603 living-donor liver transplants were performed in the United States, compared to 8925 liver transplants from deceased donors

...

"There are several notable differences between living donor kidney transplants and living donor liver transplants. For example, living donor liver transplant is a more complicated surgery and poses greater risk to the donor. According to the OPTN 2020 Annual Report, from 2015–2019, the rehospitalization rate for living liver donors was twice that of living kidney donors up to 6 weeks after transplant (4.7% vs 2.4%). One year post transplant, the cumulative rehospitalization rate was 11.0% for living liver donors and 4.8% for living kidney donors.

"The risk of dying because of living donation is also higher for liver donors compared to kidney donors. The National Kidney Association states that the odds of dying during kidney donation are about 3 in 100,000, while estimates for risk of death for living liver donors range from 1 in 500 to 1 in 1000. But some of these estimates are from 10 or more years ago, and outcomes have likely improved

...

"In addition to a more complex surgery, surgeons also have a smaller time window in which to transplant a liver than than they do to transplant a kidney. A kidney can remain viable in cold storage for 24–36 hours, and it can be transported via commercial airlines cross country. Livers have to be transplanted within 8–12 hours, according to the OPTN website. For living donation, the graft needs to be transplanted within about 4 hours, Samstein noted; this poses a logistical challenge for a national organ paired donation program.

"We worked around that with the idea that we would move the donor rather than the organ," he said. The program will require a donor (and a support person) to travel to the recipient's transplant center where the surgery will be performed. While 3 of the 15 pilot paired donation transplant centers are in New York City, the other programs are scattered across the country, meaning a donor may have to fly to a different city to undergo surgery.

"Including the preoperative evaluation, meeting the surgical team, the surgery itself, and follow-up, the donor could stay for about a month. The program offers up to $10,000 of financial assistance for travel expenses (for both the donor and support person), as well as lost wages and dependent care (for the donor only). Health insurance coverage will also be provided by the pilot program, in partnership with the American Foundation for Donation and Transplant.

...

"The 1-year pilot program is set to begin when the program conducts its first match run — an algorithm will help match pairs who are enrolled in the program. About five to seven enrolled pairs would be ideal for the first match run, a UNOS spokesperson said. It is possible that the 1-year pilot program could run without performing any paired transplants, but that's unlikely if multiple pairs are enrolled in the system, the spokesperson said. At the time of this story's publication, the one enrolled pair are a mother and daughter who are registered at the UCHealth Transplant Center in Colorado."

Preparing for a drug-resistant bacteria pandemic---vaccines and challenge trials

 Axel Ockenfels recently alerted me that "The German National Academy of Sciences Leopoldina has established a working group to analyze the economic causes of the problem of global increase in pathogens resistant to antimicrobial agents, and develop better incentives for developing antibiotics and possible solutions. "

I sent him some quick thoughts, as follows:

"one direction that seems potentially worth exploring is vaccines for bacteria pathogens.  Most of our vaccines are antiviral, but there are some vaccines against bacterial infection, even though we mostly deal with bacteria through post-infection antibiotics.  But antibiotic discovery has lots of problems, both economic and technical. And it appears that vaccine technology has advanced a lot, given the speed with which Covid vaccines were developed.  So I wonder if it wouldn’t make sense to start now to develop vaccines against some of the bacteria that we think might be candidates for developing antibody resistance, so that when those variants show up, we’ll be able to protect lots of people from getting infected by vaccinating them. 

 And challenge trials would be very useful for that, since pre-pandemic it’s hard to do conventional trials of a vaccine against a disease that most people don’t get. Challenge trials wouldn’t necessarily be very hazardous if the relevant bacteria aren’t yet highly antibiotic resistant, since the diseases would be curable… (The assumption here is that a vaccine against say, conventional tetanus, would also be protective against antibiotic-resistant tetanus, which might be true since the evolutionary pressure to evade a new vaccine is likely very different from the long evolutionary path that leads to resistance to an existing antibiotic..)"

********

Earlier posts, on antibiotics here, and vaccine challenge trials.

Lobster traps, whales, and the enforcement of informal property rights

 An experiment to protect whales from becoming entangled in the long ropes that connect lobster traps on the sea floor to buoys on the surface might also change some equilibria among lobster fisherman.

The WSJ has this story:

Endangered Whales Get Lifeline From High-Tech Lobster Traps. Lobstermen are testing equipment designed to help North American right whales avoid deadly entanglements   By Eric Niiler

"Lobstermen have long used buoys to mark the location of their traps. The ropeless systems are designed to limit whales’ risk of entanglement by keeping the buoys and their ropes stowed underwater on the traps until it is time to check the traps. 

...

"Another challenge that could stand in the way of broad use of ropeless gear involves alerting other fishermen to the presence of lobster traps—whose location, in the absence of buoys, can be harder to identify. Conflict between lobstermen with fixed gear and fishermen who drag nets along the seafloor has long been a problem along the New England coast, federal officials said.

"Computer scientists at the Allen Institute for AI—a Seattle-based nonprofit research organization founded by late Microsoft co-founder Paul Allen—are developing an app to share the location of ropeless gear with other fishermen and regulators, according to Henry Milliken, supervisory research fishery biologist at NOAA’s Northeast Fisheries Science Center in Woods Hole."

********

Earlier, on a different aspect of the lobstering equilibrium:

Thursday, September 3, 2009

Policing the lobster commons

"Lobsters are caught in traps that sit on the sea floor, marked by (and recovered via) buoys that float above, connected to the trap by a rope. Lobstermen in Maine are known for policing who sets traps where by cutting the lines (or threatening to cut the lines) of lobstermen who set traps outside of their territory. From time to time there's a question about whether the state should limit certain areas to local lobstermen. Now is such a time..."

Lin Ostrom coauthored a paper on this:

Schlager, Edella, and Elinor Ostrom. "Property-rights regimes and natural resources: a conceptual analysis." Land economics (1992): 249-262.

"The enforcement of the de facto proprietor rights was borne entirely by the lobstermen of each village. The sanction that  they used against anyone who violated communal rules was gear destruction. ...The easiest means of destroying traps is to cut the rope by which the traps are attached to buoys."

Challenge trials for future Covid vaccines are still needed, by Stanley Plotkin and Josh Morrison

 Covid is still with us, new vaccines are needed and will likely continue to be needed into the forseeable future, and the case for human challenge trials to speed selection among promising candidates is stronger than ever.  Two veteran advocates make the case:

Human Challenge Trials Hold Promise for Next-Generation COVID Vaccines— These investigations could accelerate effective development of a pan-coronavirus vaccine as well by Stanley Plotkin, MD, and Josh Morrison, JD November 7, 2022

"Two years ago, the prospect of deliberately infecting fully informed volunteers with COVID-19 to aid in vaccine research and development was controversial. We and many others argued that the risks were justifiable, and the reservations of some bioethicists did not deter nearly 40,000 people from over 160 countries from expressing interest in volunteering for these investigations, called human challenge trials. Yet in the end, while they have been extensively pursued in the U.K.*, there were no such studies in the U.S.

"We have made great strides against COVID-19 illness in the form of vaccination and treatments, but there are still thousands of deaths in the U.S. every week.

...

"The White House hosted a summit on the issue in July, showcasing the myriad ways researchers are going about developing new vaccines. There are hundreds of candidates in early stages around the world, but the resources devoted to COVID-19 vaccine research are a fraction of what they were 2 years ago. Human challenge trials can greatly speed the selection of the most promising in this field of candidates, providing scientific and economic benefits over uniform reliance on large field studies.

...

"The use of human challenge trials offers the greatest promise for testing intranasal vaccines for their ability to reduce infection and transmission. In the case of a live attenuated vaccine, something as simple as regular nasal swabbing can reveal just how much of the live virus is present in the nose over time -- and how much would spread when a patient sneezes, for example.

...

"There are obviously risks to COVID-19 challenge studies, and it was on these grounds that initial proposals for such research faced opposition. However, the risk of death is now lower than it was early on in the pandemic given better immune protection garnered from both vaccination and natural exposure, and various treatments options further reduce the risk.

Of course, long-COVID still looms large, but this risk can also be managed by selecting trial participants at lower risk of serious illness, as more severe COVID-19 illness is correlated with lingering post-COVID symptoms. Ultimately, if COVID-19 becomes endemic, long-COVID may well be a threat to everyone, whether or not they sign up for a challenge trial -- all the more reason we must act quickly to develop vaccines that stop transmission.

"We believe that volunteers are perfectly capable of considering these risks rationally. Those who decide to make a potential sacrifice for the good of humanity should be lauded, not dismissed as naive. (Notably, a study of the nearly 40,000-strong prospective volunteers organized by 1Day Sooner showed that their risk tolerance was the same as a control group, and they were driven primarily by altruistic motivations.)"

"Stanley Plotkin, MD, is professor emeritus in pediatrics at the University of Pennsylvania, a veteran vaccinologist, and a board member of 1Day Sooner, an organization that advocates on behalf of challenge trial volunteers. Josh Morrison, JD, is co-founder and president of 1Day Sooner, and a founder of Waitlist Zero and the Rikers Debate Project."

********

Earlier:

Monday, June 20, 2022

Report of a SARS-CoV-2 human challenge trial. In Britain.

* Josh Morrison writes:

there are four COVID challenge studies announced or underway in the UK, though only imperial [the study above] has published results. Besides the imperial one, there’s an Oxford reinfection study, 

https://www.ox.ac.uk/news/2021-04-19-human-challenge-trial-launches-study-immune-response-covid-19 (interestingly the talk one of our staff saw indicated they were having a difficult time getting any infections in previously infected people even when using doses 1,000 times higher than the infectious imperial dose).

 

There has also been an Imperial delta study that’s recruiting now — 

https://www.imperial.ac.uk/infectious-disease/research/human-challenge/covhic002/register-your-interest/

 

And HVIVO has announced an omicron challenge study, though I’m not sure that will happen. 

https://investors.vaxart.com/news-releases/news-release-details/vaxart-announces-agreement-hvivo-develop-worlds-first-human

Josh Morrison profiled in Vox

 Josh Morrison, the founder of WaitlistZero and 1DaySooner, is an unusually energetic and effective effective altruist.   

Here's a profile in Vox:

Josh Morrison took risks for science, and he thinks you can, too. From kidney donations to human challenge trials for Covid-19 vaccines, Josh Morrison shows the vast good any individual can do. By Muizz Akhtar

"Morrison first became familiar with this kind of direct public health participation when he read about kidney donations in the New Yorker when he was a law student in 2009. In the piece, people explained why they gave their kidneys to strangers in need — though there was slight risk to donors, the reward and benefit for the recipients was more than worth it. Two years later, he donated a kidney himself.

...

“The basic logic of my work in general is to try to use a sort of identity politics to get better political decision-making,” Morrison told me. “So with kidney donation, the theory is if kidney donors are more empowered in the political system as a sort of identity group, then the system will treat donors better and that will mean more people donate.”

HT: Frank McCormick

**********

I've mentioned Josh Morrison in many of my posts...

Eliciting beliefs is a difficult task: Danz, Vesterlund and Wilson in the AER

 Experimental economists have long been faced with the difficulty of eliciting coherent beliefs from participants in experiments, even when they seem to act in a way consistent with having coherent beliefs.  This is consistent with the psychological view that beliefs in the full Bayesian sense may not closely correspond to people's internal psychological representation of the world. So techniques for belief elicitation that would work well for idealized utility maximizers may not be ideal for human subjects.

Here's a thoughtful effort to come to grips with that.

Belief Elicitation and Behavioral Incentive Compatibility  by David Danz, Lise Vesterlund, Alistair J. Wilson AMERICAN ECONOMIC REVIEW  VOL. 112, NO. 9, SEPTEMBER 2022  (pp. 2851-83)

Abstract: "Subjective beliefs are crucial for economic inference, yet behavior can challenge the elicitation. We propose that belief elicitation should be incentive compatible not only theoretically but also in a de facto behavioral sense. To demonstrate, we show that the binarized scoring rule, a state-of-the-art elicitation, violates two weak conditions for behavioral incentive compatibility: (i) within the elicitation, information on the incentives increases deviations from truthful reporting; and (ii) in a pure choice over the set of incentives, most deviate from the theorized maximizer. Moreover, we document that deviations are systematic and center-biased, and that the elicited beliefs substantially distort inference."

"We argue that to secure truthful revelation, elicitation mechanisms need to not only be incentive compatible in a purely theoretical sense, but also in a behavioral one. We propose for assessment two weak conditions for behavioral incentive compatibility, that information on deployed incentives increases truthful revelation; and that most participants, when given a choice over the pure incentives, select the outcome thought to be uniquely maximizing under the mechanism (i.e., a requirement of behavioral incentive compatibility for a representative agent).

"To demonstrate we explore a state-of-the-art belief elicitation, the binarized scoring rule (BSR) (Hossain and Okui 2013). The BSR is seen as a particularly promising alternative to elicitations requiring risk neutrality because its incentive compatibility expands to arbitrary EU preferences—in fact, to any decision-maker who maximizes the overall chance of winning a prize. Building on the insights of Roth and Malouf (1979), this is achieved by linking reported beliefs to a pair of state-contingent lotteries, where for each distinct belief, the mechanism provides a lottery pair with a stochastically dominant reduction. That is, decision-makers who maximize their chance of winning are given strict incentivizes under the BSR to reveal their true belief.

"In addition to being incentive compatible for a wider set of preferences, initial empirical evidence shows that the BSR outperforms its narrower forerunner, the quadratic scoring rule (Hossain and Okui 2013; Harrison and Phillips 2014). Weakened theoretical assumptions and evidence for superior relative performance has quickly rendered the BSR the preferred elicitation.3  However, limited evidence exists on whether subjects behave in a truth-telling manner, and the conservative reporting patterns that identified failures in quadratic-scoring elicitations have also been detected in BSR elicitations. For example, in Babcock et al. (2017), despite the qualitative comparative statics for beliefs mirroring behavior, the elicited reports appeared overly conservative."

...[and from the conclusion]

"In pursuing improved elicitations, we need to be cognizant that we are designing mechanisms for behavioral agents. In this respect, our findings and proposed tests for behavioral incentive compatibility relate to Li’s (2017) concepts of obvious dominance and obvious strategy proofness. Both our work and Li (2017) stress the importance of considering cognitive limitations (in addition to a broader set of preferences) when designing incentive compatible mechanisms. However, while Li (2017) provides a theoretical criterion of a mechanism’s incentive compatibility for a class of cognitively limited agents, our work stresses the importance of, and provides means to, testing whether a theoretically incentive compatible mechanism is behaviorally incentive compatible in an empirical sense. As in the BSR, relatively weak-seeming theoretical assumptions permit the design of fully separating mechanisms, to measure beliefs at arbitrary precision. But such precision may well be costly—where we need to empirically test that the assumptions put in place hold, and that behavioral agents actually perceive truthful revelation as beneficial.

"Our study has proposed weak conditions for behaviorally incentive compatible elicitations and provided diagnostic tools for checking them. The hope is that new elicitations will be assessed against and succeed in passing these standards. Given the challenges associated with this task though, we caution that it may be time to question whether it is reasonable to assume that participants in our studies hold exact probabilistic beliefs, let alone our ability to use monetary incentives to elicit such beliefs at arbitrary precision. Instead of taking our results as a call for the development of mechanisms that are incentive compatible for an ever-more-general class of decision-maker, we might instead ask whether the necessary economic inferences could be drawn with less-precise measurements, where the incentives for truthful reporting can be simpler and starker.63 For example, in discrete settings it may be sufficient to elicit the event the participants deem most likely and incentivize the elicitation by offering compensation only in the event that the report is correct.64 In continuous settings, the same can be achieved by paying participants if the true population outcome falls within some bounds around their guess.65 Alternatively, it may be sufficient to determine whether a belief lies within a certain fixed interval. This allows for deviations between the potential intervals to come at a higher perceived cost and may still provide the information necessary for inference.66 For example, suppose that in understanding individual behavior we wish to elicit the belief that an opponent will select action A or B, and that the individual’s predicted behavior theoretically depends on the belief on A exceeding a 30 percent cutoff. Rather than eliciting the precise belief that action A is chosen, it may secure more reliable and truthful reporting to instead focus the elicitation on whether or not the belief on A exceeds the theoretical cutoff. If elicited beliefs are collected primarily as controls or for auxiliary tests of a behavioral mechanic, inference may be improved with starker incentives over coarser elicitations.

"While there are many paths to improve belief elicitation, we propose two simple assessments: that information on the incentives increases truthful reporting, andt hat most participants when given a choice over the pure set of incentives select the theorized maximizer. In demonstrating the very substantial inferential consequences from using biased elicitations, our results serve as a call for elicitations to be incentive compatible both theoretically and behaviorally, but also as a strong caution against elicitations that rely on incentives that decrease truthful reporting."

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One quick thought I have is that when binary lottery games were introduced in Roth, A. E., & Malouf, M. W. (1979), it was to allow the predictions of utility maximizing theories to be precisely specified, rather than to control the behavior of the experimental subjects.

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Not so long ago I posted about another paper in the AER that deals with simple and robust ways of eliciting beliefs about others' behavior.

Tuesday, March 1, 2022

Targeting High Ability Entrepreneurs Using Community Information: Mechanism Design in the Field By Reshmaan Hussam, Natalia Rigol, and Benjamin N. Roth

"Mechanisms designed to elicit truthful reporting in the laboratory sometimes are cumbersome to administer and difficult to explain.  Here's a paper that finds that simple attempts to incentivize truthful reporting (including allowing other participants to hear each report, as well as small payments for reports that conform to community consensus) can help eliminate incentives to boost family and friends, when reports concern who could make most effective use of a cash grant."