Using GIS and Simulation for Analyzing Optimal Geographical Boundaries and Organ

使用 GIS 和模拟分析最佳地理边界和器官

• 批准号: 8116986
• 负责人: Naoru Koizumi
• 金额: $ 21.48万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8116986
• 关键词: Adult; Area; Childhood; Disputes; Event; Exhibits; Exploratory/Developmental Grant; Geographic Information Systems; Goals; Health; Human; Information Systems; Insurance; Ischemia; Liver; Location; Maps; Medical; Methods; Modeling; Modification; Organ; Organ Transplantation; Policies; Policy Maker; Principal Investigator; Problem Solving; Race; Reporting; Research; Residencies; Retrieval; Science; Socioeconomic Status; System; Techniques; Technology; Time; Transplantation; United States; United States National Institutes of Health; Weight; Work; base; behavioral/social science; improved; interest; liver transplantation; meetings; mortality; organ allocation; programs; public health relevance; simulation; social science research; web page

DESCRIPTION (provided by applicant): Existing studies of organ transplantation report various disparities in access. Disparities have been found in terms of race, socioeconomic status, insurance type and the location of candidate's residency. While these disparities tend to coexist, disparity associated with candidates' locations or "geographical disparity" is the first and foremost discussed. To remedy this, the importance of redrawing the organ distribution boundaries has been discussed in recent years. No rigorous method for redrawing has, however, been explored. Our research team thus proposes to develop an analytical framework for optimizing both organ allocation and boundary creation by applying some cutting-edge techniques involving Discrete Event Simulation (DES) and Geographic Information Systems (GIS) based mapping. The proposed system differs from the existing system in two main respects. First, the boundary is drawn real-time based on the location of liver retrieval and the maximum cold ischemia time allowed. Second, the proposed system minimizes geographical disparity in receiving an organ in addition to the other policy objectives embedded in the current system, such as prioritizing the candidates with a higher medical urgency and compatibility with the organ that became available. This is a multi-objective optimization problem in which two or more policy goals could exhibit trade-off relationships. The commonly-used method of weighting will be applied to solve this problem. As the main final product, the research team intends to provide policy makers with an interactive GIS-based open simulation webpage that visualizes: (i) geographical boundaries of organ distribution areas that meet specific objectives and conditions related to organ allocation, and (ii) important consequences of employing such an allocation and boundary system, in particular, alleviating geographical disparities in access to organ transplantation. The primary interest of the proposed research is to see how an optimal organ allocation system developed by our systems science technologies can achieve a more equitable and efficient organ allocation system. While the disparities in organ allocations have been evident irrespective of the type of organ, they are most disputed in liver transplants. The research team thus plans to focus on liver transplant in the proposed study although a successful model could be modified and extended to deal with the allocation systems of other organs. In addition, we will focus on the adult transplants although appropriate modifications could be made to establish an equivalent framework for pediatric transplants. PUBLIC HEALTH RELEVANCE: While the importance of redrawing the organ distribution boundaries has been discussed in recent years, no rigorous method for the redrawing has been explored. Our research team proposes an analytical framework using Geographical Information Systems and Discrete Event Simulations to identify such boundaries and build an allocation system that reduces geographical disparity within each boundary. Our work has the potential to revolutionize the system of organ allocation in the United States, making it more just and more efficient.

描述（由申请人提供）：现有的器官移植研究报告了获得器官的各种差异。在种族、社会经济地位、保险类型和候选人居住地方面存在差异。虽然这些差异往往并存，但与候选人所在地有关的差异或“地域差异”是首先讨论的问题。为了解决这个问题，近年来已经讨论了重新划分器官分布边界的重要性。然而，没有严格的重绘方法被探索。因此，我们的研究团队建议开发一个分析框架，通过应用离散事件模拟（DES）和基于地理信息系统（GIS）的映射等尖端技术来优化器官分配和边界创建。拟议的制度与现行制度主要有两个不同之处。首先，基于肝脏获取的位置和允许的最大冷缺血时间实时绘制边界。第二，拟议的系统最大限度地减少了接受器官的地理差异，以及现行系统中的其他政策目标，例如优先考虑具有较高医疗紧急性的候选人以及与可用器官的兼容性。这是一个多目标优化问题，其中两个或两个以上的政策目标可以表现出权衡关系。本文将采用常用的加权法来解决这一问题。作为主要的最终产品，研究小组打算为政策制定者提供一个基于GIS的交互式开放模拟网页，该网页可视化：（i）满足与器官分配相关的特定目标和条件的器官分配区域的地理边界，以及（ii）采用这种分配和边界系统的重要后果，特别是减轻获得器官移植的地理差异。拟议研究的主要兴趣是看看我们的系统科学技术开发的最佳器官分配系统如何实现更公平和更有效的器官分配系统。 虽然无论器官类型如何，器官分配的差异都很明显，但在肝脏移植中最有争议。因此，研究小组计划在拟议的研究中专注于肝脏移植，尽管成功的模型可以修改和扩展以处理其他器官的分配系统。此外，我们将重点关注成人移植，尽管可以进行适当的修改以建立儿科移植的等效框架。 公共卫生关系：虽然近年来已经讨论了重新绘制器官分布边界的重要性，但没有探索重新绘制的严格方法。我们的研究团队提出了一个分析框架，使用地理信息系统和离散事件模拟来识别这些边界，并建立一个分配系统，减少每个边界内的地理差异。我们的工作有可能彻底改变美国的器官分配系统，使其更加公正和高效。

项目成果

Efficient Computing Budget Allocation for Finding Simplest Good Designs.

高效的计算预算分配，寻找最简单的良好设计

• DOI: 10.1080/0740817x.2012.705454
• 发表时间: 2013-01-01
• 期刊: IIE transactions : industrial engineering research & development
• 作者: Jia QS;Zhou E;Chen CH
• 通讯作者: Chen CH

An Efficient Simulation Budget Allocation Method Incorporating Regression for Partitioned Domains.

• DOI: 10.1016/j.automatica.2014.03.011
• 发表时间: 2014-05-01
• 期刊: AUTOMATICA
• 影响因子: 6.4
• 作者: Brantley, Mark W.;Lee, Loo Hay;Chen, Chun-Hung;Xu, Jie
• 通讯作者: Xu, Jie

Redesigning Organ Allocation Boundaries for Liver Transplantation in the United States.

• DOI: 10.1007/978-3-319-01848-5_2
• 发表时间: 2014
• 期刊: Proceedings of the International Conference on Health Care Systems Engineering. International Conference on Health Care Systems Engineering (2013 : Milan, Italy)

Optimal Computing Budget Allocation for Particle Swarm Optimization in Stochastic Optimization.

• DOI: 10.1109/tevc.2016.2592185
• 发表时间: 2017-04
• 期刊: IEEE transactions on evolutionary computation : a publication of the IEEE Neural Networks Council
• 作者: Zhang S;Xu J;Lee LH;Chew EP;Wong WP;Chen CH
• 通讯作者: Chen CH

Improved retransplant outcomes: early evidence of the share35 impact.

改善再移植结果：share35影响的早期证据。

• DOI: 10.1016/j.hpb.2018.01.007
• 发表时间: 2018
• 期刊: HPB : the official journal of the International Hepato Pancreato Biliary Association
• 作者: Brooks,JosephT;Koizumi,Naoru;Neglia,Elizabeth;Gdoura,Bilel;Wong,TinaW;Kwon,Chang;Smith,TonyE;Ortiz,Jorge
• 通讯作者: Ortiz,Jorge