Featured Article: Building Optimized Adaptive Interventions

January 18, 2017:

Every year in the United States, 800,000 deaths are directly attributable to behavioral factors like smoking and alcohol use.mostfig Interventions that help people modify their risky behavior could save many lives. Because adaptive interventions (also called dynamic treatment regimens) adjust based on participant need or preference, they have the capacity to increase intervention effectiveness and/or decrease cost and patient burden.

Two research projects at The Methodology Center develop methods for optimizing interventions and methods for adaptive interventions. These projects were developed from a common research agenda, and they remain deeply connected. The multiphase optimization strategy (MOST) for optimizing interventions sometimes employs factorial experiments to select what should be included in an intervention. The sequential, multiple assignment, randomized trial (SMART) is a special case of the factorial experiment. In the 2014 article “Optimization of behavioral dynamic treatment regimens based on the sequential, multiple assignment, randomized trial (SMART)” in Clinical Trials, Linda Collins and SMART researchers Inbal “Billie” Nahum-Shani and Daniel Almirall describe how to develop optimized adaptive interventions using a SMART.

Linda thinks interested researchers should understand the connection between SMART and MOST. “MOST is a comprehensive framework for development, optimization, and evaluation of all types of behavioral and biobehavioral interventions. The appropriate strategy for experimentation in the optimization phase depends on the type of intervention being developed. SMARTs are an excellent strategy for gathering the scientific information needed to optimize a time-varying adaptive intervention.” For researchers interested in SMART, MOST, or both, The Methodology Center provides advice about how to integrate MOST into a grant proposal and a list of funding opportunities that solicit the use of MOST and/or SMART.

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Reference 

Collins, L. M., Nahum-Shani, I., & Almirall, D. (2014). Optimization of behavioral dynamic treatment regimens based on the sequential, multiple assignment, randomized trial (SMART). Clinical Trials, 11, 426-434. http://doi.org/10.1177/1740774514536795

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