Sequential Multiple Assignment Randomized Trials: An Opportunity for Improved Design of Stroke Reperfusion Trials.

ABSTRACT:

Background

Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice.

Aim

To characterize a SMART design in comparison to traditional approaches for stroke reperfusion trials.

Methods

We conducted a numerical simulation study

SUBMITTER: Meurer WJ 

PROVIDER: S-EPMC5362332 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature