Display options
Share it on

Annu Rev Clin Psychol. 2012;8:21-48. doi: 10.1146/annurev-clinpsy-032511-143152. Epub 2011 Dec 12.

A "SMART" design for building individualized treatment sequences.

Annual review of clinical psychology

H Lei, I Nahum-Shani, K Lynch, D Oslin, S A Murphy

Affiliations

  1. Department of Statistics, University of Michigan, Ann Arbor, Michigan 48109, USA. [email protected]

PMID: 22224838 PMCID: PMC3887122 DOI: 10.1146/annurev-clinpsy-032511-143152

Abstract

Interventions often involve a sequence of decisions. For example, clinicians frequently adapt the intervention to an individual's outcomes. Altering the intensity and type of intervention over time is crucial for many reasons, such as to obtain improvement if the individual is not responding or to reduce costs and burden when intensive treatment is no longer necessary. Adaptive interventions utilize individual variables (severity, preferences) to adapt the intervention and then dynamically utilize individual outcomes (response to treatment, adherence) to readapt the intervention. The Sequential Multiple Assignment Randomized Trial (SMART) provides high-quality data that can be used to construct adaptive interventions. We review the SMART and highlight its advantages in constructing and revising adaptive interventions as compared to alternative experimental designs. Selected examples of SMART studies are described and compared. A data analysis method is provided and illustrated using data from the Extending Treatment Effectiveness of Naltrexone SMART study.

References

  1. Drug Alcohol Depend. 2010 Jan 15;106(2-3):164-72 - PubMed
  2. Control Clin Trials. 2004 Feb;25(1):119-42 - PubMed
  3. Behav Ther. 2009 Jun;40(2):190-204 - PubMed
  4. J Clin Child Adolesc Psychol. 2008 Jan;37(1):184-214 - PubMed
  5. Am J Addict. 2011 May-Jun;20(3):196-204 - PubMed
  6. Orphanet J Rare Dis. 2008 May 02;3:11 - PubMed
  7. Ann Oncol. 1994 Dec;5(10):921-8 - PubMed
  8. Epidemiology. 2000 Sep;11(5):550-60 - PubMed
  9. J Clin Child Adolesc Psychol. 2006 Sep;35(3):369-85 - PubMed
  10. Prev Sci. 2004 Sep;5(3):185-96 - PubMed
  11. BMC Surg. 2007 Nov 06;7:22 - PubMed
  12. Addiction. 2002 Mar;97(3):249-52 - PubMed
  13. J Am Stat Assoc. 2001 Dec 1;96(456):1410-1423 - PubMed
  14. Neuropsychiatr Dis Treat. 2009;5:215-26 - PubMed
  15. Stat Med. 2007 Jan 15;26(1):20-36 - PubMed
  16. J Subst Abuse Treat. 2009 Mar;36(2):131-45 - PubMed
  17. Stat Med. 2007 Nov 20;26(26):4687-702 - PubMed
  18. Biometrics. 2004 Mar;60(1):124-33 - PubMed
  19. Eur Arch Psychiatry Clin Neurosci. 2009 Feb;259(1):37-45 - PubMed
  20. Addiction. 2005 Nov;100(11):1594-610 - PubMed
  21. Arch Gen Psychiatry. 1999 Jun;56(6):493-502 - PubMed
  22. Drug Alcohol Depend. 2007 May;88 Suppl 2:S1-3 - PubMed
  23. J Consult Clin Psychol. 2007 Aug;75(4):594-604 - PubMed
  24. J Natl Cancer Inst. 2007 Nov 7;99(21):1613-22 - PubMed
  25. Pharm Stat. 2007 Apr-Jun;6(2):115-22 - PubMed
  26. Cancer. 1997 Dec 15;80(12):2222-9 - PubMed
  27. Schizophr Bull. 2003;29(1):15-31 - PubMed
  28. J Child Psychol Psychiatry. 2006 Jun;47(6):611-20 - PubMed
  29. J Consult Clin Psychol. 2006 Jun;74(3):468-81 - PubMed
  30. Drug Alcohol Depend. 2007 May;88 Suppl 2:S24-30 - PubMed
  31. J Consult Clin Psychol. 2000 Aug;68(4):573-9 - PubMed
  32. N Engl J Med. 1995 Jun 22;332(25):1671-7 - PubMed
  33. Drug Alcohol Depend. 2005 Aug 1;79(2):119-28 - PubMed
  34. J Stud Alcohol Suppl. 2005 Jul;(15):179-87; discussion 168-9 - PubMed
  35. Biol Psychiatry. 2000 Sep 15;48(6):605-14 - PubMed
  36. Eval Rev. 2007 Dec;31(6):515-47 - PubMed
  37. Crim Justice Rev. 2008;33(3):343-360 - PubMed
  38. J Child Adolesc Psychopharmacol. 2011 Apr;21(2):121-31 - PubMed
  39. Int J Biostat. 2010 Mar 03;6(2):Article 9 - PubMed
  40. Clin Trials. 2008;5(3):181-93 - PubMed
  41. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921 - PubMed
  42. Psychol Methods. 2012 Dec;17(4):478-94 - PubMed
  43. Psychol Methods. 2012 Dec;17(4):457-477 - PubMed
  44. Child Dev. 2004 Jul-Aug;75(4):1171-87 - PubMed
  45. Psychiatr Clin North Am. 2003 Jun;26(2):381-409 - PubMed
  46. Stat Med. 2005 Jul 15;24(13):1947-64 - PubMed
  47. Compr Psychiatry. 2012 Jan;53(1):107-15 - PubMed
  48. Stat Med. 2008 Oct 15;27(23):4678-721 - PubMed
  49. J Consult Clin Psychol. 2008 Feb;76(1):125-37 - PubMed
  50. Am J Psychiatry. 2006 Nov;163(11):1905-17 - PubMed
  51. Stat Med. 2002 Jun 30;21(12):1689-709 - PubMed
  52. JAMA. 2000 Oct 4;284(13):1689-95 - PubMed
  53. Clin Trials. 2004 Feb;1(1):9-20 - PubMed
  54. J Autism Dev Disord. 2000 Oct;30(5):393-8 - PubMed
  55. J Consult Clin Psychol. 2010 Dec;78(6):912-23 - PubMed
  56. Schizophr Bull. 2003;29(1):57-72 - PubMed
  57. Biometrics. 2002 Mar;58(1):48-57 - PubMed
  58. Biostatistics. 2012 Jan;13(1):142-52 - PubMed
  59. Epidemiology. 2000 Sep;11(5):561-70 - PubMed
  60. J Stud Alcohol Suppl. 2005 Jul;(15):170-8; discussion 168-9 - PubMed
  61. Stat Med. 2005 May 30;24(10):1455-81 - PubMed

MeSH terms

Publication Types

Grant support