TY - JOUR
T1 - Optimization of behavioral dynamic treatment regimens based on the sequential, multiple assignment, randomized trial (SMART)
AU - Collins, Linda M.
AU - Nahum-Shani, Inbal
AU - Almirall, Daniel
N1 - Funding Information:
This work was supported by Award Number P50 DA010075 from the National Institute on Drug Abuse, R03 MH097954 from the National Institute of Mental Health (Almirall), RC4 MH092722 from the National Institute of Mental Health, R01 HD073975 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, P50 CA143188 from the National Cancer Institute, and R01 DK097364 from the National Institute of Diabetes and Digestive and Kidney Diseases. Funding for this conference was made possible (in part) by 2 R13 CA132565-06 from the National Cancer Institute. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
PY - 2014/8
Y1 - 2014/8
N2 - Background and purpose A behavioral intervention is a program aimed at modifying behavior for the purpose of treating or preventing disease, promoting health, and/or enhancing well-being. Many behavioral interventions are dynamic treatment regimens, that is, sequential, individualized multicomponent interventions in which the intensity and/or type of treatment is varied in response to the needs and progress of the individual participant. The multiphase optimization strategy (MOST) is a comprehensive framework for development, optimization, and evaluation of behavioral interventions, including dynamic treatment regimens. The objective of optimization is to make dynamic treatment regimens more effective, efficient, scalable, and sustainable. An important tool for optimization of dynamic treatment regimens is the sequential, multiple assignment, randomized trial (SMART). The purpose of this article is to discuss how to develop optimized dynamic treatment regimens within the MOST framework. Methods and results The article discusses the preparation, optimization, and evaluation phases of MOST. It is shown how MOST can be used to develop a dynamic treatment regimen to meet a prespecified optimization criterion. The SMART is an efficient experimental design for gathering the information needed to optimize a dynamic treatment regimen within MOST. One signature feature of the SMART is that randomization takes place at more than one point in time. Conclusion MOST and SMART can be used to develop optimized dynamic treatment regimens that will have a greater public health impact.
AB - Background and purpose A behavioral intervention is a program aimed at modifying behavior for the purpose of treating or preventing disease, promoting health, and/or enhancing well-being. Many behavioral interventions are dynamic treatment regimens, that is, sequential, individualized multicomponent interventions in which the intensity and/or type of treatment is varied in response to the needs and progress of the individual participant. The multiphase optimization strategy (MOST) is a comprehensive framework for development, optimization, and evaluation of behavioral interventions, including dynamic treatment regimens. The objective of optimization is to make dynamic treatment regimens more effective, efficient, scalable, and sustainable. An important tool for optimization of dynamic treatment regimens is the sequential, multiple assignment, randomized trial (SMART). The purpose of this article is to discuss how to develop optimized dynamic treatment regimens within the MOST framework. Methods and results The article discusses the preparation, optimization, and evaluation phases of MOST. It is shown how MOST can be used to develop a dynamic treatment regimen to meet a prespecified optimization criterion. The SMART is an efficient experimental design for gathering the information needed to optimize a dynamic treatment regimen within MOST. One signature feature of the SMART is that randomization takes place at more than one point in time. Conclusion MOST and SMART can be used to develop optimized dynamic treatment regimens that will have a greater public health impact.
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U2 - 10.1177/1740774514536795
DO - 10.1177/1740774514536795
M3 - Article
AN - SCOPUS:84906096079
SN - 1740-7745
VL - 11
SP - 426
EP - 434
JO - Clinical Trials
JF - Clinical Trials
IS - 4
ER -