Wednesday, June 25, 2008

Decision Making Model on Stroke Prevention: Warfarin or not

An interesting talk I attended at the CORS 2008 conference in Quebec City was by Beste Kucukyazici from the Faculty of Management of McGill University. The topic of the talk was “Designing Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation”.

Beste Kucukyazici showed the study of stroke patient data to see if a decision model could be derived to systematically decide on the commencing of warfarin treatment for stroke patient and its intensity. Now my question is: will OR decision models take a bigger and bigger foothold in the future of medical arena as we start to gather more useful patient data in well-planned studies? Medical doctors tend to argue that each patient has a different case, and need to be examined on an individual basis. However, if a model such as Kucukyazici’s can prove the accuracy of its decision given real patient data, then it would probably start to weaken the doctor’s argument and favour a more systematic approach. At least, such models might help reduce the complexity of doctor’s decision making process, or even reduce chances for human errors in diagnosis.

Atrial fibrillation, which is a common arrhythmia particularly common among the elderly, is one of the major independent risk factors of stroke. Several randomized control trials have shown that long-term antithrombotic therapy with warfarin significantly reduces the risk of stroke, however, it also increases the risk of suffering a major bleed. Given the potential benefits and risks of warfarin treatment, the decisions that need to be made by the clinicians are two-fold: (i) whether to start the therapy, and (ii) the intensity of warfarin use. The objective of this study is to develop an analytical framework for designing the optimal antithrombotic therapy with a patient-centered approach. The approach seeks to create a rational framework for evaluating these complex medical decisions by incorporation of complex probabilistic data into informed decision making, the identification of factors influencing such decisions and permitting explicit quantitative comparison of the benefits and risks of different therapies.

Jason Goto on Operations Research Career Path – July 18, 2008

Jason Goto, President of AnalysisWorks, is invited by the INFORMS UBC Student Chapter to give an informal talk on O.R. career path on July 18, 2008. The event will be held at the Penthouse in the Henry Angus building on UBC campus at 2:30-3:30pm.

Invited audience include current and incoming Master of Management in Operations Research (MM in OR) students & alumni of the Centre for Operations Excellence (COE), Sauder School of Business, University of British Columbia.

Wondering what career path in OR you would like to choose?

Wondering how OR consulting is done?

Want to meet the guy who started AnalysisWorks
– one of the only OR consulting firms in Vancouver?

If you happen to be in Vancouver, then join us on Friday, July 18, 2:30-3:30pm at the Penthouse of the Henry Angus building on UBC campus.

Jason Goto, BASc Engineering, MSc Management Science: President
Jason Goto has consulted in a wide variety of projects involving the application of analytic data-driven methods. He has worked with major health care organizations, market research firms, manufacturers, and other private and public organizations. He specializes in the effective application of Operations Research and Management Science techniques including scenario analysis, statistics, forecasting, simulation, and optimization. (From

Monday, June 2, 2008

ORAHS 2008 in Toronto Canada

The 34th annual conference on Operations Research Applied to Health Services will be held in Toronto, Ontario, Canada, on July 28 - Aug 1, 2008. 

The ORAHS was formed in 1975 in Europe, and it is usually held in Europe as well. This year, however, Canada has the honour of hosting it.

Check here for more details on the ORAHS 2008 conference.

Mike Carter on New Challenges for OR Applications in Health Care

I had the pleasure of meeting Professor Michael W. Carter at the Canadian Operations Research Society conference (CORS) in Quebec City, and listening to his plenary talk on "New Challenges for Operations Research Applications in Health Care" - the kick-off talk for this year's CORS conference on May 12th, 2008.

Professor Carter is one of the Canadian leading experts in healthcare and operations research, with over 17 years of experience in OR applications in healthcare. He currently leads the Centre for Research in Healthcare Engineering, Mechanical and Industrial Engineering, University of Toronto. Click here for more information on Professor Mike Carter.

Mike has been very kind to allow me to publish his talk here on Here are some key points to take away:
  • Healthcare is North America's single largest industry; Canada spent $142 billion CDN in 2005; US spent $2 trillion.

  • Canada's per-capita spending ($3,326 USD) was half of US ($6,401 USD), and this is how it's been growing:

  • US & Canada are about the same in terms of quality of health care, access, efficiency , and equity (based on the Commonwealth Fund 2004 International Health Policy Survey)

  • A new way of looking at the healthcare system's stakeholders (no wonder it's difficult to make decisions in a hospital):
  • Challenges in healthcare system can be viewed as operations research challenges:

    • Patient flow - supply chain

    • Surgical wait list - better scheduling

    • Infectious diseases - logistics

    • Health human resources - forecasting

Mike also demonstrated the application of O.R. techniques in his own practice:

  • Ontario Wait List Management

  • Colorectal cancer screening

  • Cancer treatment centre locations

  • Health Human Resource Modelling

Thank you Mike for allowing me to write about your talk. It was delightful to see OR in action in the Canadian healthcare. We look forward to seeing the 30% potential waste of money spent in healthcare to shrink fast.