Towards fairness in Kidney Exchange Programs

Le traitement médical de choix pour la maladie rénale chronique est la transplantation d'organe. Cependant, plusieurs patients ne sont en mesure que de trouver un donneur direct avec lequel ils ne sont pas compatibles. Les Programmes de Don Croisé de Reins peuvent aider plusieurs paires donneur-patient incompatibles à échanger leur donneur entre elles. Typiquement, l'objectif principal d'un tel programme est de maximiser le nombre total de transplantations qui seront effectuées grâce à un plan d'échange. Plusieurs solutions optimales peuvent co-exister et comme la plupart correspondent à différents ensembles de patients obtenant un donneur compatible, il devient important de considérer quels individus seront sélectionnés. Fréquemment, ce problème n'est pas abordé et la première solution fournie par un solveur est choisie comme plan d'échange. Ceci peut mener à des parti-pris en faveur ou défaveur de certains patients, ce qui n'est pas considéré une approche juste. De plus, il est de la responsabilité des informaticiens de s'assurer du contrôle des résultats fournis par leurs algorithmes. Pour répondre à ce besoin, nous explorons l'emploi de multiples solutions optimales ainsi que la manière dont il est possible de sélectionner un plan d'échange parmi celles-ci. Nous proposons l'emploi de politiques aléatoires pour la sélection de solutions optimales suite à leur enumération. Cette tâche est accomplie grâce à la programmation en nombres entiers et à la programmation par contraintes. Nous introduisons aussi un nouveau concept intitulé équité individuelle. Ceci a pour but de trouver une politique juste pouvant être utilisée en collaboration avec les solutions énumerées. La mise à disposition de plusieurs métriques fait partie intégrante de la méthode. En faisant usage de la génération de colonnes en combinaison au métrique $L_1$, nous parvenons à applique la méthode à de plus larges graphes. Lors de l'évaluation de l'équité individuelle, nous analysons de façon systématique d'autres schémas d'équité tels que le principle d'Aristote, la justice Rawlsienne, le principe d'équité de Nash et les valeurs de Shapley. Nous étudions leur description mathématiques ainsi que leurs avantages et désavantages. Finalement, nous soulignons le besoin de considérer de multiples solutions, incluant des solutions non optimales en ce qui concerne le nombre de transplantations d'un plan d'échange. Pour la sélection d'une politique équitable ayant comme domaine un tel ensemble de solutions, nous notons l'importance de trouver un équilibre entre les mesures d'utilité et d'équité d'une solution. Nous utilisons le Programme de Bien-être Social de Nash afin de satisfaire à un tel objectif. Nous proposons aussi une méthodologie de décomposition qui permet d'étendre le système sous-jacent et de faciliter l'énumeration de solutions.The preferred treatment for chronic kidney disease is transplantation. However, many patients can only find direct donors that are not fully compatible with them. Kidney Exchange Programs (KEPs) can help these patients by swapping the donors of multiple patient-donor pairs in order to accommodate them. Usually, the objective is to maximize the total number of transplants that can be realized as part of an exchange plan. Many optimal solutions can co-exist and since a large part of them features different subsets of patients that obtain a compatible donor, the question of who is selected becomes relevant. Often, this problem is not even addressed and the first solution returned by a solver is chosen as the exchange plan to be performed. This can lead to bias against some patients and thus is not considered a fair approach. Moreover, it is of the responsibility of computer scientists to have control of the output of the algorithms they design. To resolve this issue, we explore the use of multiple optimal solutions and how to pick an exchange plan among them. We propose the use of randomized policies for selecting an optimal solution, first by enumerating them. This task is achieved through both integer programming and constraint programming methods. We also introduce a new concept called individual fairness in a bid to find a fair policy over the enumerated solutions by making use of multiple metrics. We scale the method to larger instances by adding column generation as part of the enumeration with the $L_1$ metric. When evaluating individual fairness, we systematically review other fairness schemes such as Aristotle's principle, Rawlsian justice, Nash's principle of fairness, and Shapley values. We analyze their mathematical descriptions and their pros and cons. Finally, we motivate the need to consider solutions that are not optimal in the number of transplants. For the selection of a good policy over this larger set of solutions, we motivate the need to balance utility and our individual fairness measure. We use the Nash Social Welfare Program in order to achieve this, and we also propose a decomposition methodology to extend the machinery for an efficient enumeration of solutions

Scalable Robust Kidney Exchange

In barter exchanges, participants directly trade their endowed goods in a constrained economic setting without money. Transactions in barter exchanges are often facilitated via a central clearinghouse that must match participants even in the face of uncertainty---over participants, existence and quality of potential trades, and so on. Leveraging robust combinatorial optimization techniques, we address uncertainty in kidney exchange, a real-world barter market where patients swap (in)compatible paired donors. We provide two scalable robust methods to handle two distinct types of uncertainty in kidney exchange---over the quality and the existence of a potential match. The latter case directly addresses a weakness in all stochastic-optimization-based methods to the kidney exchange clearing problem, which all necessarily require explicit estimates of the probability of a transaction existing---a still-unsolved problem in this nascent market. We also propose a novel, scalable kidney exchange formulation that eliminates the need for an exponential-time constraint generation process in competing formulations, maintains provable optimality, and serves as a subsolver for our robust approach. For each type of uncertainty we demonstrate the benefits of robustness on real data from a large, fielded kidney exchange in the United States. We conclude by drawing parallels between robustness and notions of fairness in the kidney exchange setting.Comment: Presented at AAAI1

Practical Algorithms for Resource Allocation and Decision Making

Algorithms are widely used today to help make important decisions in a variety of domains, including health care, criminal justice, employment, and education. Designing \emph{practical} algorithms involves balancing a wide variety of criteria. Deployed algorithms should be robust to uncertainty, they should abide by relevant laws and ethical norms, they should be easy to use correctly, they should not adversely impact user behavior, and so on. Finding an appropriate balance of these criteria involves technical analysis, understanding of the broader context, and empirical studies ``in the wild''. Most importantly practical algorithm design involves close collaboration between stakeholders and algorithm developers. The first part of this thesis addresses technical issues of uncertainty and fairness in \emph{kidney exchange}---a real-world matching market facilitated by optimization algorithms. We develop novel algorithms for kidney exchange that are robust to uncertainty in both the quality and the feasibility of potential transplants, and we demonstrate the effect of these algorithms using computational simulations with real kidney exchange data. We also study \emph{fairness} for hard-to-match patients in kidney exchange. We close a previously-open theoretical gap, by bounding the price of fairness in kidney exchange with chains. We also provide matching algorithms that bound the price of fairness in a principled way, while guaranteeing Pareto efficiency. The second part describes two real deployed algorithms---one for kidney exchange, and one for recruiting blood donors. For each application cases we characterize an underlying mathematical problem, and theoretically analyze its difficulty. We then develop practical algorithms for each setting, and we test them in computational simulations. For the blood donor recruitment application we present initial empirical results from a fielded study, in which a simple notification algorithm increases the expected donation rate by $5\%$. The third part of this thesis turns to human aspects of algorithm design. We conduct several survey studies that address several questions of practical algorithm design: How do algorithms impact decision making? What additional information helps people use complex algorithms to make decisions? Do people understand standard algorithmic notions of fairness? We conclude with suggestions for facilitating deeper stakeholder involvement for practical algorithm design, and we outline several areas for future research

Small Approximate Pareto Sets with Quality Bounds

We present and empirically characterize a general, parallel, heuristic algorithm for computing small ε-Pareto sets. The algorithm can be used as part of a decision support tool for settings in which computing points in objective space is computationally expensive. We use the graph clearing problem, a formalization of indirect organ exchange markets, as a prototypical example setting. We characterize the performance of the algorithm through ε-Pareto set size, ε value provided, and parallel speedup achieved. Our results show that the algorithm\u27s combination of parallel speedup and small ε-Pareto sets is sufficient to be appealing in settings requiring manual review (i.e., those that have a human in the loop) and real-time solutions