How one patient found errors in the algorithm making transplant decisions
ft.com
ft.com
So it not an algorithm that is flawed, it is a policy that is flawed. A policy that flawlessly and fairly executed by algorithm exactly as it was designed.
I'm not saying the policy was bad or fair. I have no idea to be honest. If you have one liver and two patients, then it's always going to be hard choice. But I don't think it is helpful to say the algorithm was misbehaving when it was not.
In fact, as mentioned in article, the outcomes of the algorithm are regularly checked by humans. And when they found a genuine bug (misclassifying people with liver cancer) the algorithm was fixed. Isn't that more or less exactly what you want. Humans thinking about policy, then having a computer executing the policy, while humans regularly check its output to see if the algorithm aligns with the intention.
Favoring older patients could be better at that or worse. But I'd suspect it's worse unless there is data proving otherwise.
Maybe genetically modified pig organs will eliminate the supply shortfall in organs and get rid of the power trip these jokers enjoy so much.
People with moral values don’t and shouldn’t avoid this kind of work to make sure that they care about accuracy, edge cases, that they continuously refine how they define utility and try to view it from a place of empathy.
Doctors and first responders make these calls often when they perform mass casualty triage, or when to declare someone’s death to enable collection of life saving organs.
Until we can customize the DNA in the organ for the intended recipient and manufacture them on demand with a short lead time, we are going to have some kind of lack of availability issue. Our issues are not a bunch of power-tripping sociopaths sitting on a hoard of organs deciding who lives or dies, they are trying to rapidly identify who is physically close enough and who genetically matches in the hours you have when an organ becomes available, and is there any opportunity for a cascade donation to be brought into the mix (is this organ compatible with someone who has a willing but incompatible donor who is compatible with someone else, and does that person have a willing but incompatible donor, and so on down the line)
(Edit: I have been informed that the paywalled article, which I cannot read, is about a UK system; I am only familiar with the kidney system in the US. This post probably does not reflect UK practice)
I personally prefer avoid being involved as much as possible in human life and death inducing procedure because that awfully stressful, but I don't see big problem on working on the software coding itself. What is problematic in this case is that the software was used to deinvolve everyone from the process and for what I understand the software developpement team was apparently tasked to make up the decision algorihtm and no human basic oversight was keeped during the attribution process.
I think you misspelled 'marketing materials' on one side or the other here.
the algorithms come from academic societies, and looks like this:
https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS...
Many marketing materials contain cheatsheets for such established decision algorithms, to encourage doctors keep the material around.
At the end of the day, triage is always a hard thing to do, but it is based in the idea of optimizing for the best global outcome at the expense of specific individual outcomes.
I personally would have no qualms about implementing the algorithm design in code (the organ score is going to be computed by hand or computed by code regardless, might as make a tool that saves time and mistakes), and would have no problem participating in the algorithm design if I had the appropriate expertise.
At the end of the day I'd rather live in a world where there is a known, predictable process for these decisions instead of an informal network of professionals making game-time decisions.