Robust Queueing Theory

We propose an alternative approach for studying queues based on robust optimization. We model the uncertainty in the arrivals and services via polyhedral uncertainty sets, which are inspired from the limit laws of probability. Using the generalized central limit theorem, this framework allows us to model heavy-tailed behavior characterized by bursts of rapidly occurring arrivals and long service times. We take a worst-case approach and obtain closed-form upper bounds on the system time in a multi-server queue. These expressions provide qualitative insights that mirror the conclusions obtained in the probabilistic setting for light-tailed arrivals and services and generalize them to the case of heavy-tailed behavior. We also develop a calculus for analyzing a network of queues based on the following key principles: (a) the departure from a queue, (b) the superposition, and (c) the thinning of arrival processes have the same uncertainty set representation as the original arrival processes. The proposed approach (a) yields results with error percentages in single digits relative to simulation, and (b) is to a large extent insensitive to the number of servers per queue, network size, degree of feedback, and traffic intensity; it is somewhat sensitive to the degree of diversity of external arrival distributions in the network

Stochastic analysis via robust optimization

Thesis: Ph. D., Massachusetts Institute of Technology, Sloan School of Management, Operations Research Center, 2016.Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (pages 167-174).To evaluate the performance and optimize systems under uncertainty, two main avenues have been suggested in the literature: stochastic analysis and optimization describing the uncertainty probabilistically and robust optimization describing the uncertainty deterministically. Instead, we propose a novel paradigm which leverages the conclusions of probability theory and the tractability of the robust optimization approach to approximate and optimize the expected behavior in a given system. Our framework models the uncertainty via polyhedral sets inspired by the limit laws of probability. We characterize the uncertainty sets by variability parameters that we treat as random variables. We then devise a methodology to approximate and optimize the average performance of the system via a robust optimization formulation. Our framework (a) avoids the challenges of fitting probability distributions to the uncertain variables, (b) eliminates the need to generate scenarios to describe the states of randomness, and (c) demonstrates the use of robust optimization to evaluate and optimize expected performance. We illustrate the applicability of our methodology to analyze the performance of queueing networks and optimize the inventory policy for supply chain networks. In Part I, we study the case of a single queue. We develop a robust theory to study multi-server queues with possibly heavy-tailed primitives. Our methodology (a) provides approximations that match the diffusion approximations for light-tailed queues in heavy traffic, and (b) extends the framework to analyze the transient behavior of heavy-tailed queues. In Part II, we study the case of a network of queues. Our methodology provides accurate approximations of (a) the expected steady-state behavior in generalized queueing networks, and (b) the expected transient behavior in feedforward queueing networks. Our approach achieves significant computational tractability and provides accurate approximations relative to simulated values. In Part III, we study the case of a supply chain network. Our methodology (a) obtains optimal base-stock levels that match the optimal solutions obtained via stochastic optimization, (b) yields optimal affine policies which oftentimes exhibit better results compared to optimal base-stock policies, and (c) provides optimal policies that consistently outperform the solutions obtained via the traditional robust optimization approach.by Nataly Youssef.Ph. D

Stochastic optimization in supply chain networks: averaging robust solutions

Abstract We propose a novel robust optimization approach to analyze and optimize the expected performance of supply chain networks. We model uncertainty in the demand at the sink nodes via polyhedral sets which are inspired from the limit laws of probability. We characterize the uncertainty sets by variability parameters which control the degree of conservatism of the model, and thus the level of probabilistic protection. At each level, and following the steps of the traditional robust optimization approach, we obtain worst case values which directly depend on the values of the variability parameters. We go beyond the traditional robust approach and treat the variability parameters as random variables. This allows us to devise a methodology to approximate and optimize the expected behavior via averaging the worst case values over the possible realizations of the variability parameters. Unlike stochastic analysis and optimization, our approach replaces the high-dimensional problem of evaluating expectations with a low-dimensional approximation that is inspired by probabilistic limit laws. We illustrate our approach by finding optimal base-stock and affine policies for fairly complex supply chain networks. Our computations suggest that our methodology (a) generates optimal base-stock levels that match the optimal solutions obtained via stochastic optimization within no more than 4 iterations, (b) yields optimal affine policies which often times exhibit better results compared to optimal base-stock policies, and (c) provides optimal policies that consistently outperform the solutions obtained via the traditional robust optimization approach

Robust transient analysis of multi-server queueing systems and feed-forward networks

Abstract We propose an analytically tractable approach for studying the transient behavior of multi-server queueing systems and feed-forward networks. We model the queueing primitives via polyhedral uncertainty sets inspired by the limit laws of probability. These uncertainty sets are characterized by variability parameters that controlthedegreeofconservatismofthemodel.Assumingtheinter-arrivalandservice timesbelongtosuchuncertaintysets,weobtainclosed-formexpressionsfortheworst case transient system time in multi-server queues and feed-forward networks with deterministic routing. These analytic formulas offer rich qualitative insights on the dependence of the system times as a function of the variability parameters and the fundamental quantities in the queueing system. To approximate the average behavior, wetreatthevariabilityparametersasrandomvariablesandinfertheirdensitybyusing ideas from queues in heavy traf?c under re?ected Brownian motion. We then average theworstcasevaluesobtainedwithrespecttothevariabilityparameters.Ouraveraging approach yields approximations that match the diffusion approximations for a single queue with light-tailed primitives and allows us to extend the framework to heavytailed feed-forward networks. Our methodology achieves signi?cant computationa

Robust transient analysis of multi-server queueing systems and feed-forward networks

Abstract We propose an analytically tractable approach for studying the transient behavior of multi-server queueing systems and feed-forward networks. We model the queueing primitives via polyhedral uncertainty sets inspired by the limit laws of probability. These uncertainty sets are characterized by variability parameters that control the degree of conservatism of the model. Assuming the inter-arrival and service times belong to such uncertainty sets, we obtain closed-form expressions for the worst case transient system time in multi-server queues and feed-forward networks with deterministic routing. These analytic formulas offer rich qualitative insights on the dependence of the system times as a function of the variability parameters and the fundamental quantities in the queueing system. To approximate the average behavior, we treat the variability parameters as random variables and infer their density by using ideas from queues in heavy traffic under reflected Brownian motion. We then average the worst case values obtained with respect to the variability parameters. Our averaging approach yields approximations that match the diffusion approximations for a single queue with light-tailed primitives and allows us to extend the framework to heavy-tailed feed-forward networks. Our methodology achieves significant computational tractability and provides accurate approximations for the expected system time relative to simulated values

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research