论文标题

肾脏交换计划中公平计划的适应,比较和实际实施

Adaptation, Comparison and Practical Implementation of Fairness Schemes in Kidney Exchange Programs

论文作者

St-Arnaud, William, Carvalho, Margarida, Farnadi, Golnoosh

论文摘要

在肾脏交换计划(KEP)中,每个参与的患者都与不兼容的供体一起注册。没有不兼容患者的捐助者也可以注册。然后,KEP通常通过供体交换来最大化患者的总体利益。利益的这种汇总会质疑潜在的个人患者差异,以访问KEP的移植。在多个交换计划是最佳或近距离的情况下,仅考虑这一功利目标可能会成为一个问题。实际上,当前的KEP策略是全有或全无的,这意味着仅确定一个交换计划。每个患者都被选为该独特解决方案的一部分。在这项工作中,我们寻求找到一项政策,以考虑患者正在解决方案的可能性。为了指导我们的政策的确定,我们将大众公平计划调整为KEP,以平衡最大化功利目标的常规方法。公平和功利目标的不同组合被建模为具有指数变量数量的圆锥程序。我们提出了一种专栏生成的方法,以实践有效地解决它们。最后,我们从效用和公平得分的平衡方面对不同方案进行了广泛的比较,并验证了文献中基准实例的方法的可伸缩性。

In Kidney Exchange Programs (KEPs), each participating patient is registered together with an incompatible donor. Donors without an incompatible patient can also register. Then, KEPs typically maximize overall patient benefit through donor exchanges. This aggregation of benefits calls into question potential individual patient disparities in terms of access to transplantation in KEPs. Considering solely this utilitarian objective may become an issue in the case where multiple exchange plans are optimal or near-optimal. In fact, current KEP policies are all-or-nothing, meaning that only one exchange plan is determined. Each patient is either selected or not as part of that unique solution. In this work, we seek instead to find a policy that contemplates the probability of patients of being in a solution. To guide the determination of our policy, we adapt popular fairness schemes to KEPs to balance the usual approach of maximizing the utilitarian objective. Different combinations of fairness and utilitarian objectives are modelled as conic programs with an exponential number of variables. We propose a column generation approach to solve them effectively in practice. Finally, we make an extensive comparison of the different schemes in terms of the balance of utility and fairness score, and validate the scalability of our methodology for benchmark instances from the literature.

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