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@RISK Crucial in Live Donor Kidney Transplant Study

@RISK Crucial in Live Donor Kidney Transplant Study
Living donor kidney transplantation is the preferred treatment for advanced renal failure. Roughly 20-25% of living donors can have asymmetry between their kidneys’ size and efficiency in filtration abilities. With a 10% or greater size difference between the two kidneys, doctors typically perform an additional test to measure the function of each kidney as a guide to select which kidney to transplant (they use the smaller, less efficient kidney for transplantation). Most transplant centers arbitrarily consider size and functional asymmetry of less than 10% as clinically insignificant, and asymmetry of more than 20% as a cut-off for transplantation, the concern being that the smaller kidney may not be healthy enough to be desirable for donation.

Dr. Bekir Tanriover, Assistant Professor of Internal Medicine at University of Texas Southwestern Medical Center, wanted to examine kidney transplant asymmetry more closely. “When you have more than a 10% difference in kidney size, how does this asymmetry translate into how well the kidney functions once it is transplanted in the recipient? How much kidney asymmetry is actually acceptable?”

To tackle these questions, Tanriover and his colleagues conducted a retrospective study of 100 kidney donors who had asymmetric kidneys, gathering three measurements from each patient: the kidney size (volume), filtration efficiency, and biopsy scores, and plugged them into @RISK.

Figure 1: A shows a scatter plot of kidney size

Figure 1: A shows a scatter plot of kidney size (i.e., ‘Donated Volume’) versus the recipient’s outcome (measured as estimated glomerular filtration rate after 1 year). B shows split renal function test results versus patient outcome. Graph A shows a clearly defined positive correlation between kidney size and patient outcome.

The model showed a clear correlation between donor kidney size and recipient outcomes. In fact, the model showed that kidney size was the only variable that truly mattered when it came to the three measurements, negating the need for any more invasive testing on the donor kidneys.

Dr. Tanriover also conducted a sensitivity analysis in @RISK to determine if it is safe to transplant a kidney that has extreme functional asymmetry, or if the patient should wait for a kidney from a deceased donor. “The risk of receiving a preemptive living renal transplant with any extreme [functional difference], as long as adequate donor kidney volume is transplanted, outweighs the benefit of waiting for a deceased donor renal transplant with higher function,” Tanriover writes in the study, which appears in an upcoming issue of Transplantation. “The reason for this is that the preemptive kidney transplantation offers lower mortality and allograft failure risk as compared with patients who received a transplant while on dialysis.”

 » Read the full case study

Play Ball! Palisade Software Used in Award-Winning Sports Analytics Research
Baseball fans, take note: next time you're looking to place a bet on a game, you may want to use @RISK. That's what DePaul University professor Clayton Graham did to create his baseball wagering model, presented at the prestigious ninth annual 2015 MIT Sloan Sports Analytics Conference. Dr. Graham's research submission, “Diamonds on the Line: Profits through Investment Gaming,” topped the “Business of Sports” track and earned third place overall.

Dr. Graham discusses how he uses Palisade’s DecisionTools Suite to create a baseball investment model to calculate the probability of winning individual games and the economic consequences of each wager based against each game’s betting line.

In the paper, Dr. Graham discusses how he uses Palisade’s DecisionTools Suite to create a baseball investment model to calculate the probability of winning individual games and the economic consequences of each wager based against each game’s betting line. Additionally, the research sought to determine the optimal bet size, based upon the risk tolerances of the investor.

“Palisade’s DecisionTools Suite was invaluable to the success of this lengthy project, as it quickly and easily computed the myriad statistical scenarios,” said Dr. Graham. “Baseball has a seemingly infinite set of possibilities with each at-bat, and the intricacies of determining what may happen would be impossible to determine manually, with any degree of expediency. DecisionTools Suite is also very easy to use and intuitive because it operates in Microsoft Excel. I can say, without hesitation, that this project would not have been possible without DecisionTools Suite and the technical support Palisade offers.”

 » View the recorded presentation
 » Read the full paper
 » Read the press release  

Licensing Options

There are three easy ways to get the DecisionTools Suite for your students:


Course Licenses available from Palisade. These are economical, annually renewing bulk licenses for both
network lab and laptop installation. Palisade offers a complimentary Live Web Training session to all instructors who order a Course License.
» Learn more

Student Versions from Palisade. These are 12-month versions available for purchase individually by students through either the Palisade web site or the school store.
» Learn more

Textbook Editions available bundled with textbooks.
These are time- and model-limited licenses.
» Learn more

Get DecisionTools Suite 6 for your course by contacting:

AddressPalisade Academic Sales    
800-432-7475 / 607-277-8000

Teaching Tips & Examples

The DecisionTools Suite is a great way to present quantitative techniques in a straightforward, easy-to-understand way for students.

Hospital Capacity
The purpose of this @RISK model is to see how many hospitals are required to accommodate all patients in various scenarios. Because of various circumstances, the actual numbers of beds available for these patients are uncertain, and these are modelled with normal distributions. Explore the example file below to find the probabilities that a given number of hospitals is not able to accommodate all of the patients in a given scenario.

» Download the Excel model

Tech Tip of the Month

Iterations versus Simulations in @RISK

What's the difference between iterations and simulations in Simulation Settings? Which one should I set to which number?

An iteration is a smaller unit within a simulation. At each iteration, @RISK draws a new set of random numbers for the @RISK distribution functions in your model, recalculates all open workbooks or projects, and stores the values of all designated outputs. At the end of a simulation, @RISK prepares any reports you have specified.

For example, if you run 5000 iterations and 3 simulations, then at the end of the analysis you can look at three histograms for each @RISK output. Each histogram summarizes the 5000 values for the 5000 iterations of one of the three simulations.

» Learn more about Iterations vs. Simulations
» View other Techniques and Tips here

Featured White Paper

The DecisionTools Suite is part of complex analyses published in white papers.

A Value Based Approach to Enterprise Risk Management in the Engineering and Construction Industry
by Dr. Sean Paul de la Rosa

The main purpose of enterprise risk management is to improve decision making within an organisation. This is achieved by defining the risk appetite and limits for the organisation. This paper explains the use of techniques developed by Sim Segal in his book, Corporate Value of Enterprise Risk Management, and develops a more quantitative approach that seeks to link risk exposures to organizational value.

The author of this paper sets the stage with eight different risk scenarios. He then uses @RISK to obtain estimates of the impact on revenue, costs and cash flow for each of the scenarios along with a sensitivity analysis showing which of the eight scenarios has the most inherent risk and residual risk.

Palisade Corporation  Read the full paper here

Palisade Corporation

The Academic Global Leader in
Risk and Decision Analysis
Palisade Corporation is the world's leading provider of risk and decision analysis software and solutions. Founded in 1984, its products @RISK and the DecisionTools Suite are used by over 95% of the Fortune 100, in nearly every industry around the world. Palisade is headquartered in New York State, and has offices in London, Sydney, Rio de Janeiro, and Tokyo.

What is The DecisionTools Suite?
The DecisionTools Suite is the world’s only integrated set of risk and decision analysis programs. The Suite includes @RISK for Monte Carlo simulation, PrecisionTree for decision trees, and TopRank for “what if” sensitivity analysis. In addition, DecisionTools Suite comes with StatTools for statistical analysis and forecasting, NeuralTools for predictive neural networks, and Evolver and RISKOptimizer for optimization. All programs work together seamlessly, and all integrate completely with Microsoft Excel for ease of use and maximum flexibility.

The Suite is offered in three affordable and flexible licensing options for those in academia: Student Versions, Course Licenses and Full Academic Versions.

» Schools using Palisade software
Textbooks using Palisade software

In This Issue

» @RISK Crucial in Live
   Donor Kidney
   Transplant Study

» Play Ball! Palisade
   Software Used in
   Sports Analytics

» Licensing Options

» Teaching Tips &

   Hospital Capacity

» Tech Tip
   Iterations versus Simulations
   in @RISK

» Featured White Paper
   A Value Based Approach to
   ERM in the Engineering and
   Construction Industry

» About Palisade and the
   DecisionTools Suite

Keep in Touch
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