Organ transplantation is often the last resort for treating end-stage illnesses, but managing transplant wait-lists is challenging because of organ scarcity and the complexity of assessing donor-recipient compatibility. In this paper, we develop a data-driven model for (real-time) organ allocation using observational data for transplant outcomes. Our model integrates a queuing-theoretic framework with unsupervised learning to cluster the organs into “organ types”, and then construct priority queues (associated with each organ type) wherein incoming patients are assigned. To reason about organ allocations, the model uses synthetic controls to infer a patient’s survival outcomes under counterfactual allocations to the different organ types{–} the model is trained end-to-end to optimise the trade-off between patient waiting time and expected survival time. The usage of synthetic controls enable patient-level interpretations of allocation decisions that can be presented and understood by clinicians. We test our model on multiple data sets, and show that it outperforms other organ-allocation policies in terms of added life-years, and death count. Furthermore, we introduce a novel organ-allocation simulator to accurately test new policies.

Significant effort has been placed on developing decision support tools to improve patient care. However, drivers of real-world clinical decisions in complex medical scenarios are not yet well-understood, resulting in substantial gaps between these tools and practical applications. In light of this, we highlight that more attention on understanding clinical decision-making is required both to elucidate current clinical practices and to enable effective human-machine interactions. This is imperative in high-stakes scenarios with scarce available resources. Using organ transplantation as a case study, we formalize the desiderata of methods for understanding clinical decision-making. We show that most existing machine learning methods are insufficient to meet these requirements and propose iTransplant, a novel data-driven framework to learn the factors affecting decisions on organ offers in an instance-wise fashion directly from clinical data, as a possible solution. Through experiments on real-world liver transplantation data from OPTN, we demonstrate the use of iTransplant to: (1) discover which criteria are most important to clinicians for organ offer acceptance; (2) identify patient-specific organ preferences of clinicians allowing automatic patient stratification; and (3) explore variations in transplantation practices between different transplant centers. Finally, we emphasize that the insights gained by iTransplant can be used to inform the development of future decision support tools.

The COVID-19 global pandemic is a threat not only to the health of millions of individuals, but also to the stability of infrastructure and economies around the world. The disease will inevitably place an overwhelming burden on healthcare systems that cannot be effectively dealt with by existing facilities or responses based on conventional approaches. We believe that a rigorous clinical and societal response can only be mounted by using intelligence derived from a variety of data sources to better utilize scarce healthcare resources, provide personalized patient management plans, inform policy, and expedite clinical trials. In this paper, we introduce five of the most important challenges in responding to COVID-19 and show how each of them can be addressed by recent developments in machine learning (ML) and artificial intelligence (AI). We argue that the integration of these techniques into local, national, and international healthcare systems will save lives, and propose specific methods by which implementation can happen swiftly and efficiently. We offer to extend these resources and knowledge to assist policymakers seeking to implement these techniques.

Transplant-organs are a scarce medical resource. The uniqueness of each organ and the patients' heterogeneous responses to the organs present a unique and challenging machine learning problem. In this problem there are two key challenges: (i) assigning each organ "optimally" to a patient in the queue; (ii) accurately estimating the potential outcomes associated with each patient and each possible organ. In this paper, we introduce OrganITE, an organ-to-patient assignment methodology that assigns organs based not only on its own estimates of the potential outcomes but also on organ scarcity. By modelling and accounting for organ scarcity we significantly increase total life years across the population, compared to the existing greedy approaches that simply optimise life years for the current organ available. Moreover, we propose an individualised treatment effect model capable of addressing the high dimensionality of the organ space. We test our method on real and simulated data, resulting in as much as an additional year of life expectancy as compared to existing organ-to-patient policies.