Waiting for organ transplantation: results of an analysis by an Institute of Medicine Committee. (English) Zbl 1137.62393

Gibbons, Robert D.; Duan, Naihua; Meltzer, David; Pope, Andrew; Penhoet, Edward D.; Dubler, Nancy N.; Francis, Charles; Gill, Barbara; Guinan, Eva; Henderson, Maureen; Ildstad, Suzanne T.; King, Patricia A.; Martinez-Maldonado, Manuel; Mclain, George E.; Murray, Joseph; Nelkin, Dorothy; Spellman, Mitchell W.; Pitluck, Sarah

Biostatistics 4, No. 2, 207-222 (2003).

Summary: One of the most visible and contentious issues regarding the fairness of the original system of organ procurement and allocation is the argument that it resulted in great disparities in the total amount of time a patient waited for an organ (i.e., the time from registration at a transplantation center to transplant), depending on where he or she lived. In an attempt to resolve this debate, the Congress charged the National Academy of Sciences, Institute of Medicine to perform an independent study of the original system and proposed rule changes. In an analysis of approximately 68 000 transplant waiting list records, the committee developed several conclusions and recommendations largely specific to liver transplantation policies. The purpose of this paper is to describe both the results of the study and the statistical foundations of the mixed-effects multinomial logistic regression model that led to the committee’s conclusions.

MSC:

62P10	Applications of statistics to biology and medical sciences; meta analysis
92C50	Medical applications (general)