Information, Discretion, and Overshoot in Organ Allocation: An Experimental Test of Out-of-Sequence Offers

Last registered on August 20, 2026

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Pre-Trial

Trial Information

General Information

Title

Information, Discretion, and Overshoot in Organ Allocation: An Experimental Test of Out-of-Sequence Offers

RCT ID

AEARCTR-0019341

Initial registration date

August 11, 2026

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published

August 20, 2026, 8:33 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Name

Glenn Dutcher

Affiliation

University of North Carolina at Charlotte

Contact Primary Investigator

Other Primary Investigator(s)

PI Name

Ellen Green

PI Affiliation

PI Name

Jesse Schold

PI Affiliation

PI Name

Darren Stewart

PI Affiliation

Additional Trial Information

Status

In development

Start date

2026-08-11

End date

2027-08-11

Keywords

Behavior, Health, Lab

Additional Keywords

Organ allocation, waitlist design, experimental economics, out-of-sequence, deceased donor kidney

JEL code(s)

C90, C91, D82, D91, D47, I11

Secondary IDs

Prior work

This trial does not extend or rely on any prior RCTs.

Abstract

This study tests whether human decision-makers in a simulated organ allocation setting deviate from rational behavior when given discretion to reorder a transplant waitlist ("out-of-sequence" offers). Participants act as an organ allocation agent choosing whether to list a donor organ and, if listed, whether to promote identified high-acceptance-probability candidates ahead of their default waitlist position. The design varies the amount of information about candidate types (none, partial, or full) across three simulated organ-quality markets (high, median, and low quality), each calibrated so a rational, profit-maximizing benchmark strategy is well defined. The study measures whether participants over-reorder the queue (promoting candidates beyond the point that improves placement) or over-list organs (listing when a rational benchmark would decline), relative to the model's optimal predictions.

External Link(s)

Registration Citation

Citation

Dutcher, Glenn et al. 2026. "Information, Discretion, and Overshoot in Organ Allocation: An Experimental Test of Out-of-Sequence Offers." AEA RCT Registry. August 20. https://doi.org/10.1257/rct.19341-1.0

Sponsors & Partners

Experimental Details

Interventions

Intervention(s)

Participants make a series of incentivized decisions in the role of an organ allocation agent. In each round, they decide whether to list a simulated donor organ and, if listed, whether and how to reorder a 4-candidate waitlist before extending offers. The amount of information they have about which candidates are likely to accept the organ is varied (none, partial, or full), and the underlying organ quality is varied (high, median, or low).

Intervention Start Date

2026-08-11

Intervention End Date

2027-08-11

Primary Outcomes

Primary Outcomes (end points)

(1) Re-ordering count (number of promotions performed), compared to the model's optimal promotion count k*; (2) Entry/listing decision (list vs. decline), compared to the model's optimal entry decision; (3) Unconditional waste (probability the organ goes unplaced, counting non-listing as waste); (4) Expected waitlist rank of the accepted candidate (E[W|accepted]), a measure of departure from the default fairness-based queue order.

Primary Outcomes (explanation)

Primary concern is entry/exit choice of the agent and how many times they choose to re-order, conditional on the market and the information condition. The behavioral interest is in over-re-ordering - observed promotions exceeding the model's optimal count k* in a given information/market cell - and over-listing - listing an organ when the rational entry benchmark (comparing expected payoff to the non-listing punishment) implies exit. Both are measured relative to exact rational benchmarks. The rational-agent outcomes are compared against a scenario where no re-ordering can occur, such that the ability to go out-of-sequence is compared against not offering this option and, furthermore, how both compare against non-risk-neutral, "behavioral" agents.

Secondary Outcomes

Secondary Outcomes (end points)

Expected stopping position/sequence position of the accepted offer; number of high-priority candidates "leap-frogged" (contacted after a lower-priority candidate was promoted past them); realized profit relative to optimal profit. We also are interested in how the order of the information condition leads to differential learning.

Secondary Outcomes (explanation)

Experimental Design

We will use a mixed between/within design. Participants are randomly assigned to one of three simulated "market" conditions (manipulated between subjects) and complete a sequence of incentivized allocation decisions under four information conditions (manipulated within subjects) that vary how much candidate-level information is revealed before the decision. The within-subjects conditions are presented as contiguous blocks of five periods each (20 periods total), with block order counterbalanced across participants. In each period, participants make an entry decision (whether to process a simulated case) and, conditional on entry, a costly sequencing decision over candidates. Participant behavior is compared against an optimal benchmark and against pre-specified alternative decision rules, to test (a) whether participants take the costly action more than the benchmark prescribes, (b) whether they enter more than the benchmark prescribes, and (c) whether any such departures are stable across the session or attenuate with within-session experience (order and learning effects).

Experimental Design Details

Not available

Randomization Method

Random assignment performed by the platform: participants are randomly assigned to one of three market-quality arms; within each market arm, participants are assigned round-robin to one of four block-order sequences.

Randomization Unit

Individual participant.

Was the treatment clustered?