Pinar Keskinocak

Georgia Institute of Technology | GT · School of Industrial and Systems Engineering

Malaria continues to be a major source of morbidity and mortality in sub-Saharan Africa. Timely, accurate, and effective case management is critical to malaria control. Proactive community case management (ProCCM) is a new strategy in which a community health worker “sweeps” a village, visiting households at defined intervals to proactively provide...

Objective: This study examined adherence to clinical practice guidelines (CPGs) and U.S. Food and Drug Administration (FDA) medication labels when prescribing psychotropic medications to Medicaid-insured children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective analysis was conducted with 2016-2018 Medicaid claims d...

Chad has seen a considerable reduction in cases of Guinea worm disease (or dracunculiasis) in domestic dogs in recent years. Tethering of dogs and application of Abate ® larvicide to water sources appear to have contributed to this progress, but with 767 reported dog cases in 2021, accelerating elimination of the disease in Chad may require additio...

Background Despite the successes of the Global Polio Eradication Initiative, substantial challenges remain in eradicating the poliovirus. The Sabin-strain (live-attenuated) virus in oral poliovirus vaccine (OPV) can revert to circulating vaccine-derived poliovirus (cVDPV) in under-vaccinated communities, regain neurovirulence and transmissibility,...

This work addresses a home health care scheduling problem faced by home care agencies. In home health care scheduling, there is a desire to retain consistency with respect to the home health aide servicing each patient; this consistency is referred to as continuity of care. To address this preference for continuity of care, we propose a rolling hor...

Chad has seen a considerable reduction in cases of Guinea worm disease (or dracunculiasis) in domestic dogs in recent years. Tethering of dogs and application of Abate larvicide to water sources appear to have contributed to this progress, but with 767 reported dog cases in 2021, accelerating elimination of the disease in Chad may require additiona...

Objective Senegal has demonstrated catalytic improvements in national coverage rates for early childhood vaccination, despite lower development assistance for childhood vaccines in Senegal compared with other low-income and lower-middle income countries. Understanding factors associated with historical changes in childhood vaccine coverage in Seneg...

Guinea worm (GW) disease (or dracunculiasis) is currently transmitted among dogs in Chad, which presents risks for the human population. We studied how interventions implemented at different levels might reduce the spread of GW disease (geographically and over time) and what levels of interventions might accelerate elimination. We built a multiple-...

Background: Split liver transplantation (SLT), where a single donor liver is divided for transplantation to 2 recipients, has the potential to increase the availability of size-matched livers for pediatric candidates and expand the supply of donor organs available for adult candidates. Although SLT is a well-established technique, the number of SL...

Guinea worm disease (or dracunculiasis) is currently transmitted among dogs in Chad, which presents risks for the human population. We studied how interventions implemented at different levels might reduce the spread of Guinea worm disease (geographically and over time) and what levels of interventions might accelerate elimination. We built a multi...

We study the capacity planning and allocation decisions for multiple heterogeneous resources, considering potential demand scenarios, where each demand requests a subset of the available resource types simultaneously at a specified time, location, and duration (smRmD). We model this problem as a two-stage stochastic integer program and consider two...

With over 100,000 patients on the kidney transplant waitlist in 2019, it is important to understand if and how the functional status of a patient may change while on the waitlist. Recorded both at registration and just prior to transplantation, the Karnofsky Performance Score measures a patient’s functional status and takes on values ranging from 0...

Introduction: Senegal has demonstrated catalytic improvements in national coverage rates for early childhood vaccination, despite lower development assistance for childhood vaccines in Senegal compared to other low and lower-middle income countries. Understanding factors associated with historical changes in childhood vaccine coverage in Senegal, a...

Background Childhood vaccination, family planning, healthcare access, and women's empowerment are goals targeted by the Sustainable Development Goals (SDG). Barriers to healthcare access impede vaccination, and tackling goals holistically could create larger gains than siloed efforts. We studied Nepal, Senegal, and Zambia to test the association be...

Background Pediatric immunization is important for preventing potentially life-threatening diseases in children. Over time, the number of recommended pediatric vaccines has increased and is likely to increase further as new vaccines are developed. Given the different number of doses for available vaccines and various constraints (e.g., the appropri...

Introduction The essential components of a vaccine delivery system are well-documented, but robust evidence on how and why the related processes and implementation strategies drive catalytic improvements in vaccination coverage are not well established. To address this gap, we identified critical success factors that may have led to substantial imp...

Academic researchers, government agencies, industry groups, and individuals have produced forecasts at an unprecedented scale during the COVID-19 pandemic. To leverage these forecasts, the United States Centers for Disease Control and Prevention (CDC) partnered with an academic research lab at the University of Massachusetts Amherst to create the U...

We consider the problem of allocating multiple heterogeneous resources geographically and over time to meet demands that require some subset of the available resource types simultaneously at a specified time, location, and duration. The objective is to maximize the total reward accrued from meeting (a subset of) demands. We model this problem as an...

Widespread product shortages during the COVID-19 pandemic and other emergencies have prompted several large studies of how to make supply chains more resilient. In this article we leverage these studies, as well as the academic literature, to provide a review of our state of knowledge about supply chain resilience. To do this, we (i) classify the f...

During a pandemic, vaccination plays an important role in reducing the infection spread or adverse outcomes such as hospitalizations and deaths. However, a vaccine’s overall public health impact depends not only on its initial efficacy, but also its efficacy against emerging variants and ease and speed of distribution. For example, mutations in SAR...

Introduction Diagnostic tests can play an important role in reducing the transmission of infectious respiratory diseases, particularly during a pandemic. The potential benefit of diagnostic testing depends on at least 4 factors: (1) how soon testing becomes available after the beginning of the pandemic and (2) at what capacity; (3) compliance with...

We propose a simulation-optimization-based methodology to improve the way that organ transplant offers are made to potential recipients. Our policy can be applied to all types of organs, is implemented starting at the local level, is flexible with respect to simultaneous offers of an organ to multiple patients, and takes into account the quality of...

SignificanceThis paper compares the probabilistic accuracy of short-term forecasts of reported deaths due to COVID-19 during the first year and a half of the pandemic in the United States. Results show high variation in accuracy between and within stand-alone models and more consistent accuracy from an ensemble model that combined forecasts from al...

Introduction The essential components of a vaccine delivery system are well-documented, but robust evidence on how and why the related processes and implementation strategies prove effective at driving coverage is not well-established. To address this gap, we identified critical success factors associated with advancing key policies and programs th...

Background Thousands of school systems have struggled with the decisions about how to deliver education safely and effectively amid the COVID19 pandemic. This study evaluates the public health impact of various school reopening scenarios (when, and how to return to in-person instruction) on the spread of COVID19. Methods An agent-based simulation...

We consider the problem of allocating multiple heterogeneous resources geographically and over time to meet demands that require some subset of the available resource types simultaneously at a specified time, location, and duration. The objective is to maximize the total reward accrued from meeting (a subset of) demands. We model this problem as an...

SARS-CoV-2 vaccination strategies were designed to reduce COVID-19 mortality, morbidity, and health inequities. To assess the impact of vaccination strategies on disparities in COVID-19 burden among historically marginalized populations (HMPs), e.g. Black race and Hispanic ethnicity, we used an agent-based simulation model, populated with census-tr...

Background Depression is a treatable disease, and untreated depression can lead to serious health complications and decrease the quality of life. Therefore, prevention, early identification, and treatment efforts are essential. Screening has an essential role in preventive medicine in the general population. Ideally, screening tools detect patients...

Recently, the Centers for Disease Control and Prevention (CDC) has worked with other federal agencies to identify counties with increasing coronavirus disease 2019 (COVID-19) incidence (hotspots) and offers support to local health departments to limit the spread of the disease. Understanding the spatio-temporal dynamics of hotspot events is of grea...

Introduction The essential components of a vaccine delivery system are well-documented, but robust evidence on how and why the related processes and implementation strategies drive catalytic improvements in vaccination coverage are not well established. To address this gap, we identified critical success factors that may have led to substantial imp...

Introduction The essential components of a vaccine delivery system are well-documented, but robust evidence on how and why the related processes and implementation strategies prove effective at driving coverage is not well-established. To address this gap, we identified critical success factors associated with advancing key policies and programs th...

The multiple knapsack problem with grouped items aims to maximize rewards by assigning groups of items among multiple knapsacks, without exceeding knapsack capacities. Either all items in a group are assigned or none at all. We study the bi-criteria variation of the problem, where capacities can be exceeded and the second objective is to minimize t...

Background Major depression is a treatable disease, and untreated depression can lead to serious health complications. Therefore, prevention, early identification, and treatment efforts are essential. Natural history models can be utilized to make informed decisions about interventions and treatments of major depression. Methods We propose a natur...

Objective Vaccine shortage and supply-chain challenges have caused limited access by many resource-limited countries during the COVID-19 pandemic. One of the primary decisions for a vaccine-ordering decision-maker is how to allocate the limited resources between different types of vaccines effectively. We studied the tradeoff between efficacy and r...

Background The prioritization of vaccine eligibility for different subpopulations is an important decision to curb spread and severe outcomes of epidemic infectious diseases for which vaccines become available. Using COVID-19 as a prototype, this study evaluates the public health impact of various vaccine prioritization schemes of elderly and high-...

More than 4,000 colleges and universities in the U.S. are scheduled to start a new semester in August or September, 2021. Many colleges require Covid-19 vaccination, as well as some combination of face coverings or diagnostic testing, while others do not (in some cases due to governance structure). Large state universities may especially have limit...

We study the variable selection problem in survival analysis to identify the most important factors affecting the survival time when the variables have prior knowledge that they have a mutual correlation through a graph structure. We consider the Cox proportional hazard model with a graph-based regularizer for variable selection. A computationally...

Background: After moving instruction online for more than a year, many colleges and universities are preparing to reopen and offering fully in-person classes for the Fall 2021 semester. In this paper, we study the impact of weekly testing protocols on college campuses. Methods: An extended susceptible-infectious-removed (SIR) compartmental model wa...

Background Millions of primary school students across the United States are about to return to in-person learning. Amidst circulation of the highly infectious Delta variant, there is danger that without the appropriate safety precautions, substantial amount of school-based spread of COVID-19 may occur. Methods We used an extended Susceptible-Infec...

Importance: Nationally stated goals for distributing SARS-CoV-2 vaccines included to reduce COVID-19 mortality, morbidity, and inequity using prioritization groups. However, the impact of these prioritization strategies is not well understood, particularly their effect on health inequity in COVID-19 burden for historically marginalized racial and e...

Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models provide specific, quantitative, and evaluable predictions that inform short-term...

Importance Vaccination against SARS-CoV-2 has the potential to significantly reduce transmission and COVID-19 morbidity and mortality. The relative importance of vaccination strategies and nonpharmaceutical interventions (NPIs) is not well understood. Objective To assess the association of simulated COVID-19 vaccine efficacy and coverage scenarios...

Objective To assess the value of using SARS-CoV-2 specific antibody testing to prioritize the vaccination of susceptible individuals as part of a COVID-19 vaccine distribution plan when vaccine supply is limited. Methods An extended susceptible-infected-recovered (SIR) compartmental model was used to simulate COVID-19 spread when considering diagn...

Recently, the Centers for Disease Control and Prevention (CDC) has worked with other federal agencies to identify counties with increasing coronavirus disease 2019 (COVID-19) incidence (hotspots) and offers support to local health departments to limit the spread of the disease. Understanding the spatio-temporal dynamics of hotspot events is of grea...

Objective. Screening has an essential role in preventive medicine. Ideally, screening tools detect patients early enough to manage the disease and reduce symptoms. We aimed to determine the cost-effectiveness of routine screening schedules. Methods. We used a discrete-time nonstationary Markov model to simulate the progression of depression. We ado...

Introduction Routine immunisation is a cost-effective way to save lives and protect people from disease. Some low-income countries (LIC) achieved remarkable success in childhood immunisation. Yet, previous studies comparing the relationship between economic growth and health spending with vaccination coverage have been limited. We investigated thes...

Objective: Recent mutations in SARS-CoV-2 raised concerns about diminishing vaccine effectiveness against COVID-19 caused by particular variants. Even with a high initial efficacy, if a vaccine efficacy drops significantly against variants, or if it cannot be distributed quickly, it is uncertain whether the vaccine can provide better health outcome...

Background Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19. This study evaluates the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of NPIs for COVID19 and being homebound (i.e., refraining from inter...

Background. Major depression is a treatable disease, and untreated depression can lead to serious health complications. Therefore, prevention, early identification, and treatment efforts are essential. Natural history models can be utilized to make informed decisions about interventions and treatments of major depression. Methods. We propose a natu...

Objective: To assess the value of using SARS-CoV-2 specific antibody testing to prioritize the vaccination of susceptible individuals as part of a COVID-19 vaccine distribution plan when vaccine supply is limited. Methods: A compartmental model was used to simulate COVID-19 spread when considering diagnosis, isolation, and vaccination of a cohort o...

Objective Vaccine shortage and supply-chain challenges have caused limited access by many resource-limited countries during the COVID-19 pandemic. One of the primary decisions for a vaccine-ordering decision-maker is how to allocate the limited resources between different types of vaccines effectively. We studied the tradeoff between efficacy and r...

Objectives: To evaluate the effectiveness of widespread adoption of masks or face coverings to reduce community transmission of the SARS-CoV-2 virus that causes COVID-19. Methods: We created an agent-based stochastic network simulation using a variant of the standard SEIR dynamic infectious disease model. We considered a mask order that was initiat...

Background: Vaccination against SAR-CoV-2 has the potential to significantly reduce transmission and COVID-19 morbidity and mortality. This modeling study simulated the comparative and joint impact of COVID-19 vaccine efficacy and coverage with and without non-pharmaceutical interventions (NPIs) on total infections, hospitalizations, and deaths. Me...

The flowtime network restoration problem was introduced by Averbakh and Pereira (2012 Averbakh, I and Pereira, J. (2012) The flowtime network construction problem. IIE Transactions , 44 , 681–694.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) who presented a Minimum Spanning Tree heuristic, two local search procedures, and an exa...

Objective Provide an overview of the literature on respiratory infectious disease epidemic prediction, preparedness, and response (including pharmaceutical and nonpharmaceutical interventions) and their impact on public health, with a focus on respiratory conditions such as asthma. Data Sources Published literature obtained through PubMed database...

Background Routine childhood immunization is a cost-effective way to save lives and protect people from disease. Some low-income countries (LIC) have achieved remarkable success in childhood immunization, despite lower levels of gross national income or health spending compared to other countries. We investigated the impact of financing and health...

Introduction: We quantify the effect of a set of interventions including asthma self-management education, influenza vaccination, spacers, and nebulizers on healthcare utilization and expenditures for Medicaid-enrolled children with asthma in New York and Michigan. Methods: We obtained patients' data from Medicaid Analytic eXtract files and evalua...

As the spread of COVID19 in the US continues to grow, local and state officials face difficult decisions about when and how to transition to a “new normal.” The goal of this study is to project the number of COVID19 infections and resulting severe outcomes, and the need for hospital capacity under social distancing, particularly, shelter-in-place a...

Introduction: We quantify the effect of a set of interventions including asthma self-management education, influenza vaccination, spacers, and nebulizers on healthcare utilization and expenditures for Medicaid-enrolled children with asthma in New York and Michigan. Methods: We obtained patient data from Medicaid Analytic eXtract files and evaluated...

The campaign to eradicate dracunculiasis (Guinea worm [GW] disease) and its causative pathogen Dracunculus medinensis (GW) in Chad is challenged by infections in domestic dogs, which far outnumber the dwindling number of human infections. We present an agent-based simulation that models transmission of GW between a shared water source and a large p...

Denver Public Schools (DPS) serves roughly 90,000 K–12 students using a mixed bus fleet. Developing and reviewing bus-route assignments manually has been challenging and time consuming for DPS. During 2017–2018, DPS analysts reviewed and adjusted over 700 routes assigned to approximately 200 buses, considering time and capacity feasibility. We deve...

Background The COVID-19 pandemic has driven demand for forecasts to guide policy and planning. Previous research has suggested that combining forecasts from multiple models into a single "ensemble" forecast can increase the robustness of forecasts. Here we evaluate the real-time application of an open, collaborative ensemble to forecast deaths attr...

Dedicated clinics can be established in an influenza pandemic to isolate people and potentially reduce opportunities for influenza transmission. However, their operation requires resources and their existence may attract the worried-well. In this study, we quantify the impact of opening dedicated influenza clinics during a pandemic based on an agen...

Background: Thousands of school systems have been struggling with the decisions about how to safely and effectively deliver education during the fall semester of 2020, amid the COVID19 pandemic. This study evaluates the public health impact of various school reopening scenarios (when, and how to return in-person instruction) on the spread of COVID1...

Objective: Screening for Down Syndrome (DS) includes traditional ultrasound and serum-based and cell-free DNA (cfDNA) testing. While cfDNA testing usually has superior performance, it is significantly more costly. As an alternative, a hybrid strategy combining contingent cfDNA with traditional testing is recommended when universal cfDNA screening...

Background. Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19. This study evaluates the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of NPIs for COVID19 and being homebound (i.e., refraining from comm...