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Suppose you design a system to allocate organ donation for the greater good. From one point of view, an optimized program could donate organs to the youngest possible recipient, in order to maximize the number of life years gained from each organ donation.

However, such a system would likely be seen as discriminatory because of its use of age, and would be unlikely to gain the approval of the whole of society.

“This will not be acceptable in practice,” says Nikos Trichakis, associate professor at MIT Sloan School of Management.

This kind of problem, generally speaking, is one of many problems in which effectiveness – in this case gaining the most years of life through organ donation – may conflict with the equity, defined as reasonable access to goods among many groups within society.

The tension between efficiency and equity can seem intractable. But in reality, there are ways to design systems that meet them. This is what Trichakis does. Over the past decade, he has published research analyzing variations in this problem in many areas of life, from liver transplant policy and schedule for cancer center infusions to corporate funding decisions.

“I think one of the innovations my work brings is the application of optimization and quantitative thinking and analysis to real world areas in a way that respects fairness, fairness and the expectations of society, ”Trichakis said.

For his research and teaching, Trichakis was appointed to MIT last year.

A family of engineers

Trichakis is originally from Greece and grew up in a family of engineers, which strongly influenced his own career trajectory.

“I grew up in a family where literally everyone was an engineer, my uncles, my parents,” says Trichakis. “So I guess I have the problem-solving virus. He got his undergraduate degree in electrical engineering from Aristotle University of Thessaloniki, but over time he discovered that his interests were not strictly in the field.

“I started out studying electrical engineering myself, but I’ve always loved math, and the way I think about my research is something that sits at that intersection,” notes Trichakis. “For me, those are the two things that have always turned me on.”

Partly following the example of a friend, Trichakis enrolled in a master’s program at Stanford University, where he realized that operations research was at precisely that same intersection and decided to pursue it further. He earned another master’s degree from Imperial College London, then enrolled in the MIT Sloan doctoral program.

At Sloan, Trichakis worked with Dimitris Bertsimas and Vivek Farias, two leading operational research researchers, who received his PhD in 2011. Since then he has published widely cited papers with them, among other colleagues; in all, Trichakis has published over two dozen peer-reviewed articles.

In a 2013 article published in Operational research, “Fairness, Efficiency, and Flexibility in Organ Allocation for Kidney Transplanation”, Trichakis, Bertsimas and Farias have introduced an organ transplant system which, rather than restricting the criteria of fairness or efficiency of transplants, has them in fact broadened, by letting policymakers build a priority system using a point scale based on many factors, including medical urgency, waiting time for a transplant, etc.

This system, they discovered, would increase the number of years of life gained from a given set of transplants by 8%, while meeting all the fairness criteria specified by US federal policymakers.

“When there is a shortage, there is very often a trade-off between the objectives of efficiency and also equity,” notes Trichakis. “But the reason you’re seeing these gains really is the power of quantitative thinking, the power of optimization, and the power of analysis.”

And in a widely cited Management science 2012 article, “On the Fairness-Efficiency Trade-off,” the three researchers described a broader framework for evaluating these systems in a variety of areas, from air traffic control to call center operations and care planning. health. The most efficient air traffic schedule at a given airport may favor some airlines, for example, but by quantifying this, analysts and policymakers can at least measure what academics call “the price of fairness” and develop systems on which stakeholders can agree. .

Why more debt requires more discipline

Trichakis joined the faculty at MIT in 2016, having served on the faculty at Harvard University from 2011 to 2016. At the Institute, he continued to conduct research on a diverse set of issues. For example, in a 2017 article in Management science, written with Dan Iancu and Gerry Tsoukalas, Trichakis and his co-authors discovered, somewhat paradoxically, that leveraged companies need the utmost discipline in managing their own inventories. Heavily indebted companies may be inclined to liquidate their inventories, but then quickly find themselves in depreciation, having reduced their scope of activity.

Yet Trichakis continues to focus on healthcare as an important area of ​​his research. In a 2020 article in Transplantation, Trichakis, Bertsimas and four co-authors found that a ‘continuous distribution’ framework for organ transplant allocation – one that takes into account many factors at once – also serves to reduce geographic challenges in the allocation systems for liver transplants. They estimate that a larger multifactorial system would save 500 lives per year, creating “the greatest reduction in the number of patient deaths and … the most equitable geographic distribution for a comparable organ transport burden”.

As the Covid-19 pandemic continues, Trichakis is also examining issues of vaccine processing and distribution within the same framework. But whatever the subject, he will continue to use operations research tools to find ways in which society can allocate its scarce resources with acceptable levels of efficiency and fairness for all.

“You can solve real-world problems in a very wide range of application areas, from societal and policy-making issues to operational issues within a particular industry,” says Trichakis.

About Irene J. O'Donnell

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