An approach to robustness in stable marriage and stable roommates problems

This dissertation focuses on a novel concept of robustness within the context of matching problems. Our robustness notion for the stable matching framework is motivated by the unforeseen events that may occur after a matching is computed. We define the notion of (a,b)-supermatches as a measure of robustness of a matching. An (a,b)-supermatch characterizes a stable matching such that if any combination of 'a' pairs want to leave the matching, there exists an alternative matching in which those 'a' pairs are assigned new partners, and in order to obtain the new assignment at most 'b' other pairs are broken. We first formally define the notion of (a,b)-supermatches by using one of the most famous matching problems, namely the Stable Marriage problem (SM), as the platform. We name the problem of finding an (a,b)-supermatch to the SM as the Robust Stable Marriage problem (RSM). Subsequently, we prove that RSM is NP-hard, and the decision problem for the case where a=1 (i.e. deciding if there exists a (1,b)-supermatch) is NP-complete. We also develop a constraint programming model and a number of meta-heuristic approaches to find a (1,b)-supermatch that minimizes the value of 'b' for the RSM. Following the results on the RSM, we extend the notion of (a,b)-supermatches to the Stable Roommates problem (SR), namely, the Robust Stable Roommates problem (RSR). We show that the NP-hardness is also valid for the RSR, and we also define a polynomial-time procedure for the RSR to decide if a given stable matching is a (1,b)-supermatch. Similarly, we provide a number of meta-heuristic models to solve the optimization problem for finding a (1,b)-supermatch that minimizes the value of 'b'. We conclude this dissertation by providing some empirical results on the robustness of different datasets of RSM and RSR instances

Finding robust solutions to stable marriage

We study the notion of robustness in stable matching problems. We first define robustness by introducing (a,b)-supermatches. An (a,b)-supermatch is a stable matching in which if a pairs break up it is possible to find another stable matching by changing the partners of those a pairs and at most b other pairs. In this context, we define the most robust stable matching as a (1,b)-supermatch where b is minimum. We show that checking whether a given stable matching is a (1,b)-supermatch can be done in polynomial time. Next, we use this procedure to design a constraint programming model, a local search approach, and a genetic algorithm to find the most robust stable matching. Our empirical evaluation on large instances show that local search outperforms the other approaches

Improving navigation in critique graphs

Critique graphs were introduced as a device for analysing the behaviour of conversational recommender systems. A conversational recommender allows a user to critique a recommended product with statements such as "I'd like a similar product to this one, but cheaper". A critique graph is a directed multigraph in which the nodes represent products, and a directed edge between a pair of products represents how a user can move from one product to another by tweaking a particular product feature. It has been shown that critique graphs are not symmetric: if a user critiques a product pi and is presented with product pj, critiquing product pj in the opposite manner does not necessarily return product pi. Furthermore, it might not be possible to reach all products in a catalogue starting from a given product, or as a consequence of a particular critique some products become unreachable. This latter point is quite unsatisfactory since a user would assume that it is possible to explore the full catalogue by critiquing alone. A number of approaches to overcoming this problem have been proposed in the literature. In this paper we propose a novel approach that exploits the critique graph directly. Specifically, the unreachability is a consequence of a critique graph having more than one strongly connected component. We show how the critique graph can be modified in a minor way, thereby modifying the semantics of critiquing for a given catalogue, so that all products are always reachable

Explanation in constraint satisfaction: A survey

Much of the focus on explanation in the field of artificial intelligence has focused on machine learning methods and, in particular, concepts produced by advanced methods such as neural networks and deep learning. However, there has been a long history of explanation generation in the general field of constraint satisfaction, one of the AI's most ubiquitous subfields. In this paper we survey the major seminal papers on the explanation and constraints, as well as some more recent works. The survey sets out to unify many disparate lines of work in areas such as model-based diagnosis, constraint programming, Boolean satisfiability, truth maintenance systems, quantified logics, and related areas

On the complexity of Robust Stable Marriage

Robust Stable Marriage (RSM) is a variant of the classical Stable Marriage problem, where the robustness of a given stable matching is measured by the number of modifications required for repairing it in case an unforeseen event occurs. We focus on the complexity of finding an (a, b)-supermatch. An (a, b)-supermatch is defined as a stable matching in which if any a (non-fixed) men/women break up it is possible to find another stable matching by changing the partners of those a men/women and also the partners of at most b other couples. In order to show deciding if there exists an (a, b)-supermatch is NPNP -complete, we first introduce a SAT formulation that is NPNP -complete by using Schaefer’s Dichotomy Theorem. Then, we show the equivalence between the SAT formulation and finding a (1, 1)-supermatch on a specific family of instances

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362