This is often the case for many chronic disorders, conditions for which there is no widely effective treatment, or conditions for which there are widely effective treatments but they are burdensome, costly, or carry side effects.ĭue to the waxing and waning course of many chronic disorders such as obesity, for example, a treatment that demonstrates short-term weight loss for an individual may not lead to weight loss in the long-term even if the individual remains on the same treatment (within-person heterogeneity ). This type of sequential decision-making is necessary when there is high level of individual heterogeneity in response to treatment. The management of many health disorders, such as obesity, substance use, or depression, often entails a sequential, individualized approach whereby treatment (e.g., behavioral or medical interventions, or a combination) is adapted and readapted over time in response to the specific needs and evolving status of the individual. For illustration, we discuss the development of an adaptive intervention for optimizing weight loss among adult individuals who are overweight. We discuss SMART design considerations, including common primary and secondary aims. This manuscript provides an introduction to adaptive interventions and SMARTs. Despite increasing popularity, SMARTs remain relatively new to intervention scientists.
#SEQUENTIAL MULTIPLE ASSIGNMENT RANDOMIZED TRIAL TRIAL#
The Sequential Multiple Assignment Randomized Trial (SMART)-a type of research design-was developed explicitly for the purpose of building optimal adaptive interventions by providing answers to such questions. Yet, there is often insufficient empirical evidence or theoretical basis to address these questions. Often, a wide variety of critical questions must be answered when developing a high-quality adaptive intervention. Adaptive interventions provide one way to operationalize the strategies (e.g., continue, augment, switch, step-down) leading to individualized sequences of treatment. The management of many health disorders often entails a sequential, individualized approach whereby treatment is adapted and readapted over time in response to the specific needs and evolving status of the individual.
0 kommentar(er)
