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Kidney-matching by algorithm

According to the National Kidney Foundation, thirteen people die every day while awaiting a kidney transplant. More than 3,000 new patients are added to the waiting list every month—a new name every 14 minutes. But the length of the waiting list and the insufficient supply aren’t the only issues in those deaths. The entire system is slowed by a time-consuming decision-making process that relies on individual discernment. “Who might be best suited to this kidney?” “Is this kidney the best possible match?” “Will a better match be coming in the next few months?”

Dimitris Bertsimas

Dimitris Bertsimas, the Boeing Leaders for Global Operations Professor of Management and the co-director of the MIT Sloan Operations Research Center, is cutting through red tape with an elegant algorithm designed to streamline the waiting list process, getting the right kidney to the right recipient in the shortest amount of time. In a new paper, he and MIT Sloan Assistant Professor of Operations Management Nikos Trichakis describe a pioneering model that applies machine-learning to historical data about all kidney transplants over the last decade to guide future donations.

Nikos Trichakis

At present, when a kidney is offered to a wait-listed candidate, the decision to accept or decline the organ relies primarily upon a surgeon’s experience and intuition. The physician might take into consideration the location and condition of the kidney. And might there be a higher-quality kidney or a better match available in the future? The authors maintain that the current experience-based paradigm lacks scientific rigor and is subject to the inaccuracies that plague anecdotal decision-making. As a result, as many as 20% of all kidneys obtained are discarded as unsuitable—when, in fact, they might well have been the best option.

Bertsimas’ and Trichakis’ data-driven analytics-based model predicts whether a patient will receive an offer for a deceased-donor kidney at KDPI thresholds of 0.2, 0.4, and 0.6, and at time frames of 3, 6, and 12 months. The model accounts for OPO, blood group, wait time, DR antigens, and prior offer history to provide accurate and personalized predictions. They tested datasets spanning various lengths of time to understand the adaptability of the method.

The pair is working with surgeons at Massachusetts General Hospital to create a support tool that leverages their model. They hope to give surgeons a reality check about kidneys, providing them with hard evidence of whether they can realistically expect a better donation if they decline a kidney—ultimately reducing the number of kidneys that are discarded because physicians are pessimistic about the match.

Find out more about their research.

Read the abstract.

 

Digital solutions for Africa: The 2018 MIT Sloan Africa Innovate Conference convenes at the MIT Media Lab April 7

Africa. In many ways it has a long way to travel to compete as a peer in the contemporary global marketplace. But from another perspective, the population is highly motivated to find solutions to crippling problems and incentivized to reinvent those systems that are barriers to progress. The MIT Sloan Africa Innovate Conference is an annual touchstone for just how far Africa has come and where it goes next.

Ismail Ahmed, WorldRemit founder & CEO, one of the keynote speakers at the 2018
MIT Africa Innovate Conference.

“Digitization for Inclusive Growth” is the theme of the 2018 conference, which is organized by the MIT Africa Business Club and takes place at the MIT Media Lab on April 7. Workshops and panels will evaluate the lessons of the last decade of technological advancement and explore how to leverage digitization to ensure that Africa’s progress is as inclusive as possible.

The conference will feature a Solveathon led by the MIT Solve Center. Teams of entrepreneurs will develop and pitch solutions related to coastal communities, healthcare, education, and the future of work. In addition, panels will delve into the most intractable challenges that countries on the African continent still face—challenges that require strategic innovation on a grand scale. Those panels will include investigations into:

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Healthcare: There’s an app for that

Dapo TomoriDigital doesn’t necessarily mean impersonal. At least not in the healthcare industry, according to Dapo Tomori, SF ’09, Senior Director of Medical Affairs, CNS, at Takeda Pharmaceuticals. “Digital tools give us the opportunity to personalize care to an unprecedented level,” he says. “Digital can be a better way to get information to patients, physicians, payers, and policymakers so that all of them, individually and in concert, can make more informed decisions with better outcomes.”

Dr. Tomori believes that the healthcare industry has a responsibility to continually tap the latest digital capabilities—a broad spectrum of technologies that are increasing the pertinence and personalization of information. “It’s important to channel the latest innovations in science and medicine to improve real-world patient and population outcomes. The digitization of the healthcare ecosystem improves communication on multiple levels, and communication is at the root of so many advances in healthcare. Technology innovation can enable what we call P4 medicine – predictive, preemptive, personalized, and participatory.”

It’s critically important, Dr. Tomori notes, to take into consideration behavioral factors and societal trends when developing technology-enabled patient solutions and gives as an example the current impulse to simplify our digital lives. “Our messaging, music, camera, and GPS are integrated now into a single device—our phone—which we carry with us everywhere out of necessity. People don’t want to have to keep track of additional devices, so inventing a new handheld gadget may be less helpful than inventing a phone app that accomplishes the same task.”

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From battleground to hospital room: The challenge of humanizing radar

Radar. The word conjures up images of colossal metal dishes pointed toward impending danger. Anupam Nayak, SF ’10, is out to replace that old black and white picture we now have imprinted on our brains with images of fuzzy slippers and warm blankets. She and Lucas van Ewijk, former head of the radar department at TNO, the leading Dutch research institute, and a small group of entrepreneurs have decided it’s time to free radar from its confined military identity. Radar is a powerful, versatile tool, they believe, and can be a crucial game changer in other realms. Healthcare, for example.

Anupam Nayak SF10“We realized we could install a radar device the size of a business card in a patient’s room—either at home or in the hospital—to monitor respiration and other vital signs,” Nayak says. The idea of continuous patient monitoring blossomed into the startup Applied Radar Technology, which successfully navigated three years of regulatory trials before attracting the attention of the marketplace. She and van Ewijk decided to set up a new entity, VDisha, that can truly expand radar research and commercialization into the healthcare realm. In collaboration with government-funded radar research groups in the Netherlands, their aim is to expand VDisha into a multi-million dollar international initiative, bringing in partners from research groups around the world.

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Building a better doctor

David RosenmanFeatured in FierceHealthcare’s “9 People to Watch in Healthcare,” David Rosenman, SF ’12, is changing the system one doctor at a time. Assistant Professor of Medicine at the Mayo Clinic College of Medicine and Founding Director of the Preclinical Block at the Mayo Medical School, Rosenman is creating a new breed of physicians who are well rounded and patient-centered—as adept at communication as they are at diagnosis.

Rosenman oversees the preclinical block, a transition course for medical students that takes place at the very midpoint of their medical school experience, that all-important segue between the first two preclinical and second two clinical years. The Mayo Clinic’s preclinical block is the longest and most comprehensive in medical education, spanning the breadth of healthcare—pediatrics, surgery, internal medicine, and a dozen other specialties.

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Disruptive change in healthcare delivery

Craig Bunnell, SF ’08, Chief Medical Officer at Dana-Farber Cancer Institute has been negotiating the steep hills and deep valleys of government-mandated healthcare since Massachusetts became the first state to institute health insurance reform in 2006. As healthcare providers now fear about the Affordable Care Act, the revamped system and its subsequent amendments in 2008, 2010, and 2012, disrupted the status quo, forcing organizations and individuals to rethink their positions in the marketplace.

Craig Bunnell, Dana Farber CMO and Sloan Fellow AlumAlthough Bunnell acknowledges that new health insurance realities have posed prodigious difficulties, he’s not interested in rolling back time. “Change is difficult,” Bunnell says, “but necessary. We have an ethical and economic imperative to repair this nation’s healthcare system. Yes, we felt the disruption of the Massachusetts healthcare law, but we also saw the impact. After the legislation was introduced, that percentage of uninsured in Massachusetts dropped to one to two percent—the percentage of uninsured across the rest of the country is somewhere around 14 %.” [The federal percentage has been steadily dropping under the new healthcare law.]

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