Using behavioral economics to reduce the discard rate of viable kidneys: Validating new methods to identify factors that influence the acceptance of deceased-donor kidneys

项目摘要 来自已故捐赠者的可移植肾脏正在被丢弃，而等待名单上的候选人 可以使用它们的数量继续增长。尽管所提供的肾脏的质量有助于 接受率，临床医生的决定存在很大差异。一个潜在的障碍， 改善对已故捐赠者肾脏的分配和接受是一个基本的缺乏 理解为什么一些移植中心相似肾脏的拒绝率很高， 但不是其他人。我们工作的前提是接受程度上无法解释的异质性 比率是由临床医生决策中的特殊偏好和行为偏差引起的- 制作。尽管许多偏好和偏见被假设为会影响临床医生的 对于这些决定，研究人员缺乏一种有效的工具来衡量它们。我们将试行并验证 这个平台将允许我们估计广泛的偏好和行为的影响 对录取率的偏见。为了验证我们的平台，我们将测试 临床医生在模拟环境中获得的风险偏好 实践中的追溯性接受行为。

Project Summary Viable kidneys from deceased donors are being discarded while the waitlist of candidates who could use them continues to grow. Though the quality of the offered kidney contributes to the acceptance rate, there exists a large variance in clinicians' decisions. An underlying barrier to improving the allocation and acceptance of deceased-donor kidneys is a lack of a fundamental understanding as to why the refusal rate for similar kidneys is high for some transplant centers, but not others. The premise for our work is that the unexplained heterogeneity in acceptance rates is caused by idiosyncratic preferences and behavioral biases in clinician's decision- making. Although many preferences and biases have been hypothesized to affect clinician's decisions, researchers lack a validated instrument to measure them. We will pilot and validate a platform that will allow us to estimate the influence of a wide range preferences and behavioral biases on acceptance rates. To validate our platform, we will test for correlations between clinicians' risk preferences elicited in a simulated environment to risk preferences from retrospective acceptance behavior in practice.