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 来自已故捐赠者的活体肾脏被丢弃，而等待名单上的候选人， 可以使用它们的数量继续增长。虽然提供肾脏的质量有助于 接受率，在临床医生的决定中存在很大的差异。潜在的障碍， 改善死亡供体肾脏的分配和接受是缺乏基本的 理解为什么对于一些移植中心来说，类似肾脏的拒绝率很高， 而不是其他人。我们工作的前提是，无法解释的接受异质性 率是由特殊的偏好和行为偏见，在临床医生的决定- 制作。虽然许多偏好和偏见已被假设影响临床医生的 研究人员缺乏有效的工具来衡量它们。我们将试点和验证一个 平台，使我们能够估计广泛的偏好和行为的影响， 接受率的偏差。为了验证我们的平台，我们将测试 临床医生的风险偏好在模拟环境中引起的风险偏好， 实践中的回溯接受行为。

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.