![]() ![]() RCTs are designed to test efficacy or effectiveness of an intervention compared to a control condition, while SMARTs allow identifying treatment strategies that would otherwise take multiple RCTs to evaluate. SMART designs are a generalization of conventional randomized controlled trials (RCT) that allow participants to be randomized more than once, depending on intermediate outcomes. These tailored AIs are also called deeply embedded AIs. ![]() Investigators can build more complex AIs (more deeply tailored AIs) using extra information collected on potential moderators (e.g., baseline characteristics of the individual and/or context, adherence to and/or side effects from prior treatment stages). Each stage in a SMART design corresponds to one of the critical decisions involved in the AI. Each patient is randomly assigned to initial treatment and subsequent treatments are based on the intermediate outcome and patient’s characteristics. ĪIs are said to be embedded in a SMART study. The sequential multiple assignment randomization trial (SMART) is design that involves multiple stages of randomization, and is used to develop and refine effective AIs, also known as dynamic treatment regimens (DTR), adaptive treatment strategies (ATS), multistage treatment strategies (MTS), proportionate interventions, or treatment policies. 4) decision rule(s), linking the tailoring variable(s) to the intervention components, at each critical decision point. 3) tailoring variable(s), an early indicator of the overall outcome (success or failure of the intervention). 2) intervention component(s), a set of intervention/treatment options at each critical decision point. Often there will be a huge number of potential AIs that could be used, and it is difficult to collect robust information on which perform best.Īn AI consists of four key elements: 1) critical decision point(s), comprising: the intervention to begin with when and how to measure signs of response/nonresponse how to maintain the success of the initial intervention and what interventions may be used for non-responders. This strategy would account for the patient’s treatment history and response to those treatments. An adaptive intervention (AI), sometimes referred to as dynamic treatment regimens (DTRs), is a treatment strategy that formalizes the personalization of treatment through established decision rules that recommend when and how the treatment should change. ![]()
0 Comments
Leave a Reply. |