Comparing dynamic treatment regimes using repeated-measures outcomes: modeling considerations in SMART studies.

ABSTRACT: A dynamic treatment regime (DTR) is a sequence of decision rules, each of which recommends a treatment based on a patient's past and current health status. Sequential, multiple assignment, randomized trials (SMARTs) are multi-stage trial designs that yield data specifically for building effective DTRs. Modeling the marginal mean trajectories of a repeated-measures outcome arising from a SMART presents challenges, because traditional longitudinal models used for randomized clinical trials do not take into account the unique design features of SMART. We discuss modeling considerations for various forms of SMART designs, emphasizing the importance of considering the timing of repeated measures in relation to the treatment stages in a SMART. For illustration, we use data from three SMART case

SUBMITTER: Lu X 

PROVIDER: S-EPMC4876020 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature