The Dartmouth Data, Statistics, and Optimization (D2SO) research group, led by Dr. Wesley Marrero, aims to develop decision-support tools that consider the challenges associated with their implementation in practice, such as inequity, irrational behavior, lack of interpretability, and need for flexibility. To this end, they design and apply techniques from operations research, statistics, and algorithmic fairness, with an emphasis on simulation and optimization. Some of their current work focuses on measuring and mitigating the effects of bias and inequity through statistical and optimization methods. Through this research, D2SO addresses various application areas, including mental health, cancer, neonatology, substance use disorder, cardiovascular disease, and organ transplantation.

 

 

 

 

 

 

 

Ongoing Projects:

Fair Allocation of Medications for Opioid Use Disorder Providers

 

Approximately 500,000 people have died of an opioid overdose in the U.S. over the past 20 years. Despite the evidence for the effectiveness of opioid use disorder (OUD) medications, most individuals with OUD remain untreated. Furthermore, not all individuals have the same access to OUD medications. Vulnerable populations (e.g., racially minoritized, rural, and low-income persons) are less likely to have access to OUD medications while being at increased risk of morbidity and mortality from OUD.

Integrating supervised learning and reinforcement learning, our lab in collaboration with a team from the Massachusetts General Hospital Institute for Technology Assessment will create a framework to generate fair allocation recommendations. With this framework, we intend to develop projections of OUD and overdoses that are calibrated to different populations. Based on our projections, we will offer tailored indications of where and when providers may be needed, aiming to maximize access to OUD medications while ensuring equal opportunity across demographics.

As an initial step, we are studying how the number and rate of nonfatal overdoses vary across race, sex, rural-urban divide, and socioeconomic status.

For more info: Dong, H., Yan Y., Marrero, W.J., Jalali, M.S. Impact of Race, Sex, Socioeconomic Status, and Geographical Location on Nonfatal Opioid Overdoses. Working Paper.

Funding Source: Thayer School of Engineering

Principal Investigator: Wesley Marrero

Research Team: Thadryan Sweeney, Yu Yan, Doan Pham, Ang Xiao, Huiru Dong, Mohammad Jalali

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Flexible and Easily Implementable Guidelines

 

Despite the many models developed to improve sequential decision making in medicine, those models typically cannot be implemented in their current form. To reduce the breach between theory and practice, we design sequential decision-making models that provide physicians with flexible, interpretable, and easily implementable guidelines, while continuing to improve patients’ outcomes.

To benefit from physicians’ opinions and allow for patients’ preferences in the implementation of models for sequential decision problems, we proposed a new framework for identifying sets of near-optimal treatment choices.

 

For more info: Marrero, W. J., Lavieri, M. S., Tewari, A., Sussman, J. B., & Hayward, R. A. (2021). Data-Driven Ranges of Near-Optimal Actions for Finite Markov Decision Processes. Optimization Online [Preprint]. October 5, 2021.
Available from: http://www.optimization-online.org/DB_HTML/2021/10/8618.html.

 

Funding Source: National Science Foundation

Principal Investigator: Wesley Marrero

Research Team: Zequn Chen and Miranda Scully

 

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Select Publications:

2023

Towards precision well-being in medical education. Thesen T, Marrero W, Konopasky A, Duncan M, Blackmon K. Br Med J. 2023. doi: 10.1101/2023.06.18.23291549

2022

Simulation-Based Sets of Similar-Performing Actions in Finite Markov Decision Process Models. Marrero WJ. IEEE. 2022. doi:10.1109/wsc57314.2022.10015413  

Identifying key risk factors for premature discontinuation of opioid use disorder treatment in the United States: A predictive modeling study. Stafford C, Marrero WJ, Naumann RB, Lich KH, Wakeman S, Jalali MS. Drug Alcohol Depend. 2022;1;237:109507. doi:10.1016 PMID: 35660221

2021

The Magnitude of the Health and Economic Impact of Increased Organ Donation on Patients With End-Stage Renal Disease.; Chen HF, Ali H, Marrero WJ, Parikh ND, Lavieri MS, Hutton DW. MDM Policy Pract. 2021;6(2):23814683211063418. doi:10.1177/23814683211063418. PMID: 34901442 

A machine learning approach for the prediction of overall deceased donor organ yield.; Marrero WJ, Lavieri MS, Guikema SD, Hutton DW, Parikh ND. Surgery. 2021;170(5):1561-1567. doi:10.1016/j.surg.2021.06.004. PMID: 34183178 

Optimal cholesterol treatment plans and genetic testing strategies for cardiovascular diseases.; Marrero WJ, Lavieri MS, Sussman JB. Health Care Manag Sci. 2021;24(1):1-25. doi:10.1007/s10729-020-09537-x. PMID: 33483911 

Data-Driven Ranges of Treatment Choices for Personalized Management of Hypertension. Marrero WJ, Lavieri MS, Tewari A, Sussman JB, Hayward R. Med Desic Making. 2021. 

Assessment of National Organ Donation Rates and Organ Procurement Organization Metrics.; DeRoos LJ, Zhou Y, Marrero WJ, Tapper EB, Sonnenday CJ, Lavieri MS, Hutton DW, Parikh ND. JAMA Surg. 2021;156(2):173-180. doi:10.1001/jamasurg.2020.5395. PMID: 33263743 

Interpretable policies and the price of interpretability in hypertension treatment planning. Garcia G, Steimle L, Marrero W, Sussman JB. Optimization Online. 2021. 

The Use of Organs from Donors That Do Not Meet Eligibility Criteria in the United States. Deroos L, Lavieri M, Hutton D, Marrero W, Parikh N. American J Transplant. 2021. 

Predictors of Deceased Donor Kidney Discard in the United States.; Marrero WJ, Naik AS, Friedewald JJ, Xu Y, Hutton DW, Lavieri MS, Parikh ND. Transplantation. 2017;101(7):1690-1697. doi:10.1097/TP.0000000000001238. PMID: 27163541 

Data-Driven Ranges of Near-Optimal Actions for Finite Markov Decision Processes. Marrero WJ, Lavieri M, Tewari A, Sussman JB, Hayward R. Optimization Online. 2021. 

2019

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant.; DeRoos LJ, Marrero WJ, Tapper EB, Sonnenday CJ, Lavieri MS, Hutton DW, Parikh ND. JAMA Netw Open. 2019;2(10):e1912431. doi:10.1001/jamanetworkopen.2019.12431. PMID: 31577360 

A Simulation Model to Evaluate the Implications of Genetic Testing in Cholesterol Treatment Plans. Marrero WJ, Lavieri MS, Sussman JB. 2019 Winter Simulation Conference (WSC).  2019;1020-2031. doi:10.1109/WSC40007.2019.9004735 

Projected increase in obesity and non-alcoholic-steatohepatitis-related liver transplantation waitlist additions in the United States.; Parikh ND, Marrero WJ, Wang J, Steuer J, Tapper EB, Konerman M, Singal AG, Hutton DW, Byon E, Lavieri MS. Hepatology. 2019;70(2):487-495. doi:10.1002/hep.29473. PMID: 28833326 

Development of a Predictive Model for Deceased Donor Organ Yield.; Marrero WJ, Lavieri MS, Guikema SD, Hutton DW, Parikh ND. Transplantation. 2018 ;102(8):e364. doi:10.1097/TP.0000000000002274. PMID: 29757898 

‪Modeling the Effect of Presumed Consent on Waitlist Candidate Quantities‬. DeRoos L, Marrero W, Lavieri M, Hutton D, Parikh N. Am J Transplant. 2019. 

A Simulation Model to Evaluate the Implications of Genetic Testing in Cholesterol Treatment Plans. Marrero WJ, Lavieri MS, Sussman JB. In: 2019 Winter Simulation Conference (WSC). 2019:1020-2031. doi:10.1109/WSC40007.2019.9004735 

2018

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant.; DeRoos LJ, Marrero WJ, Tapper EB, Sonnenday CJ, Lavieri MS, Hutton DW, Parikh ND. JAMA Netw Open. 2019;2(10):e1912431. doi:10.1001/jamanetworkopen.2019.12431. PMID: 31577360 

Projected increase in obesity and non-alcoholic-steatohepatitis-related liver transplantation waitlist additions in the United States.; Parikh ND, Marrero WJ, Wang J, Steuer J, Tapper EB, Konerman M, Singal AG, Hutton DW, Byon E, Lavieri MS. Hepatology. 2019;70(2):487-495. doi:10.1002/hep.29473. PMID: 28833326 

Development of a Predictive Model for Deceased Donor Organ Yield.; Marrero WJ, Lavieri MS, Guikema SD, Hutton DW, Parikh ND. Transplantation. 2018;102(8):e364. doi:10.1097/TP.0000000000002274. PMID: 29757898 No abstract available. 

The Cost-Effectiveness of Presumed Consent for Kidney Donors on Patients with End-Stage Renal Disease. Chen HF, Ali H, Marrero W, Parikh N, Lavieri MS, Hutton DW. Circ Cardiovasc Qual Outcomes. 2018. 

2017

Population-Based Analysis and Projections of Liver Supply Under Redistricting.; Parikh ND, Marrero WJ, Sonnenday CJ, Lok AS, Hutton DW, Lavieri MS. Transplantation. 2017;101(9):2048-2055. doi:10.1097/TP.0000000000001785. PMID: 28945663 

Predictors of Deceased Donor Kidney Discard in the United States.; Marrero WJ, Naik AS, Friedewald JJ, Xu Y, Hutton DW, Lavieri MS, Parikh ND. Transplantation. 2017;101(7):1690-1697. doi:10.1097/TP.0000000000001238. PMID: 27163541 

Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning.; Schell GJ, Marrero WJ, Lavieri MS, Sussman JB, Hayward RA. MDM Policy Pract. 2016;1(1):2381468316674214. doi:10.1177/2381468316674214. PMID: 30288409 

Projections in donor organs available for liver transplantation in the United States: 2014-2025.; Parikh ND, Hutton D, Marrero W, Sanghani K, Xu Y, Lavieri M. Liver Transpl. 2015;21(6):855-63. doi:10.1002/lt.24136. PMID: 25845830

2016

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant.; DeRoos LJ, Marrero WJ, Tapper EB, Sonnenday CJ, Lavieri MS, Hutton DW, Parikh ND. JAMA Netw Open. 2019;2(10):e1912431. doi:10.1001/jamanetworkopen.2019.12431. PMID: 31577360 

A Simulation Model to Evaluate the Implications of Genetic Testing in Cholesterol Treatment Plans. Marrero WJ, Lavieri MS, Sussman JB. In: 2019 Winter Simulation Conference (WSC). 2019;1020-2031. doi:10.1109/WSC40007.2019.9004735 

Projected increase in obesity and non-alcoholic-steatohepatitis-related liver transplantation waitlist additions in the United States.; Parikh ND, Marrero WJ, Wang J, Steuer J, Tapper EB, Konerman M, Singal AG, Hutton DW, Byon E, Lavieri MS. J Hepatol. 2019;70(2):487-495. doi:10.1002/hep.29473. PMID: 28833326 

Projections of non-alcoholic steatohepatitis related liver transplantation waitlist additions‬. Marrero W, Parikh N, Wang J, Steuer J, Hutton D, Byon E, Lavieri M. J Hepatol. 2016. 

‪Development of a Predictive Model for Deceased Donor Organ Yield.; Marrero WJ, Lavieri MS, Guikema SD, Hutton DW, Parikh ND. Transplantation. 2018;102(8):e364. doi:10.1097/TP.0000000000002274. PMID: 29757898

2015

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant.; DeRoos LJ, Marrero WJ, Tapper EB, Sonnenday CJ, Lavieri MS, Hutton DW, Parikh ND. JAMA Netw Open. 2019;2(10):e1912431. doi:10.1001/jamanetworkopen.2019.12431. PMID: 31577360 

A Simulation Model to Evaluate the Implications of Genetic Testing in Cholesterol Treatment Plans. Marrero WJ, Lavieri MS, Sussman JB. In: 2019 Winter Simulation Conference (WSC). 2019;1020-2031. doi:10.1109/WSC40007.2019.9004735 

Projected increase in obesity and non-alcoholic-steatohepatitis-related liver transplantation waitlist additions in the United States.; Parikh ND, Marrero WJ, Wang J, Steuer J, Tapper EB, Konerman M, Singal AG, Hutton DW, Byon E, Lavieri MS. Hepatology. 2019;70(2):487-495. doi:10.1002/hep.29473. PMID: 28833326 

Development of a Predictive Model for Deceased Donor Organ Yield.; Marrero WJ, Lavieri MS, Guikema SD, Hutton DW, Parikh ND. Transplantation. 2018;102(8):e364. doi:10.1097/TP.0000000000002274. PMID: 29757898

2013

Location of Reliable Medians on Vulnerable Networks With Stochastic Demands. Marrero W, Santiváñez J, E Melachrinoudis. IIE Ann Conf. 2013.