The optimal allocation of scarce donor livers is a contentious health care issue requiring careful analysis. The objective of this article was to design a biologically based discrete-event simulation to test proposed changes in allocation policies.
Simulation outcomes were within 1% to 2% of actual results for measures such as new candidates, donated livers, and transplants by year. The model overestimated the yearly size of the waiting list by 5% in the last year of the simulation and the total number of pretransplant deaths by 10%.
The authors created a discrete-event simulation model that represents the biology of end-stage liver disease and the health care organization of transplantation in the United States.
The authors used data from multiple sources to simulate end-stage liver disease and the complex allocation system. To validate the model, they compared simulation output with historical data.
Shechter SM, Bryce CL, Alagoz O, Kreke JE, Stahl JE, Schaefer AJ, Angus DC, Roberts MS. (2005). A clinically based discrete-event simulation of end-stage liver disease and the organ allocation process. Medical decision making : an international journal of the Society for Medical Decision Making, 25(2)