Get SMART - Understanding Sequential Multiple Assignment Randomized Trials.

Abstract

Sequential multiple assignment randomized trials (SMARTs) have been used to advance treatments for complex problems that lack clearly defined interventions.^1,2 Unlike in traditional clinical trials in which participants are randomly assigned to only one intervention or one intervention strategy,^3,4 in SMARTs participants are randomly assigned to an intervention at two or more stages of the trial. The adaptive reallocation strategy constructs a tailored or personalized strategy of interventions on the basis of the individuals' responses.^5-8 An example of a SMART design is reported in this issue of <i>NEJM Evidence</i>.⁹.