Turgay Ayer

Georgia Institute of Technology

Abstract: About one out of six inmates in the United States (U.S.) is infected with hepatitis C virus (HCV). HCV prevalence in prison systems is ten times higher than the general population, and hence prison systems offer a unique opportunity to control the HCV epidemic. In this study, we propose a restless bandit modeling framework to support hepatitis C treatment prioritization decisions in U.S. prisons. We first prove indexability for our problem and derive several structural properties of the well-known Whittle's index, based on which, we derive a closed-form expression of the Whittle's index for patients with advanced liver disease. From the interpretation of this closed-form expression, we anticipate that the performance of the Whittle's index would degrade as the treatment capacity increases; and to address this limitation, we propose a capacity-adjusted closed-form index policy. We parameterize and validate our model using real-world data from Georgia state prison system and published studies. We test the performance of our proposed policy using a detailed, clinically-realistic simulation model and show that our proposed policy can significantly improve the overall effectiveness of the hepatitis C treatment programs in prisons compared with the current practice and other benchmark policies, including the commonly used Whittle's index policy.

Biography: Turgay Ayer is the George Family Foundation Assistant Professor of Predictive Health at Industrial and Systems Engineering, and is the research director for medical decision-making in the Center for Health & Humanitarian Systems at Georgia Tech. Dr. Ayer conducts research on stochastic modeling and optimization, with applications in predictive health, medical decision making, healthcare operations, and health policy. He has been working on various projects related to different aspects of healthcare, including health outcomes research, disease prevention & control modeling, infectious disease modeling, healthcare delivery planning, new payment models, and health information exchanges. His research has been published in top tier engineering, management, and medical journals. Ayer received a B.S. in industrial engineering from Sabanci University in Istanbul, Turkey, and his M.S. and Ph.D. degrees in industrial and Systems Engineering from the University of Wisconsin - Madison