title: Decision tables and rule engines in organ allocation systems for optimal transparency and flexibility.
abstract: Organ allocation systems have become complex and difficult to comprehend. We introduced decision tables to specify the rules of allocation systems for different organs. A rule engine with decision tables as input was tested for the Kidney Allocation System (ETKAS). We compared this rule engine with the currently used ETKAS by running 11,000 historical match runs and by running the rule engine in parallel with the ETKAS on our allocation system. Decision tables were easy to implement and successful in verifying correctness, completeness, and consistency. The outcomes of the 11,000 historical matches in the rule engine and the ETKAS were exactly the same. Running the rule engine simultaneously in parallel and in real time with the ETKAS also produced no differences. Specifying organ allocation rules in decision tables is already a great step forward in enhancing the clarity of the systems. Yet, using these tables as rule engine input for matches optimizes the flexibility, simplicity and clarity of the whole process, from specification to the performed matches, and in addition this new method allows well controlled simulations.
authors.affiliation: Eurotransplant, Leiden, The Netherlands. m.schaafsma@eurotransplant.org
authors.forename: Murk
authors.initials: M
authors.lastname: Schaafsma
authors.forename: Wilfred
authors.initials: W
authors.lastname: van der Deijl
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Smits
authors.forename: Axel O
authors.initials: AO
authors.lastname: Rahmel
authors.forename: Pieter F
authors.initials: PF
authors.lastname: de Vries Robbé
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Hoitsma
mesh_terms: D000465:Algorithms; D002648:Child; D003657:Decision Making; D003661:Decision Support Techniques; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D012984:Software; D009927:Tissue and Organ Procurement / Q000379:methods*; D014180:Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D014850:Waiting Lists