Illinois researchers learn to improve intervention strategies with SMART designs

11/2/2023 10:08:21 AM Hannah Wirth

The Interdisciplinary Health Sciences Institutes (IHSI) recently hosted a webinar, Get SMART with Adaptive Interventions, for Illinois researchers who are interested in improving the efficiency and effectiveness of their intervention strategies. Led by IHSI’s Biostatistics, Epidemiology, and Research Design (BERD) team, the event attracted researchers from 23 units and 10 colleges across the Illinois campus as well as multiple external organizations. Event resources and a video recording are available.

During the event, Kelley Kidwell, a professor of Biostatistics and Associate Chair for Academic Affairs in the School of Public Health at the University of Michigan, gave an informative introduction to the sequential, multiple-assignment, randomized trials (SMART) design concept, and Illinois Social Work Prof. Liliane Windsor discussed the application of SMART designs in research.

Getting SMART

Adaptive interventions (AIs), also called dynamic treatment regimens or adaptive treatment strategies, are strategies involving sequences of decision rules to adapt or modify treatments based on a patient’s changing needs to achieve better outcomes. These strategies mimic real-life clinical, public health, socio-behavioral, social work, educational, and other professional practice.

SMARTs are used to develop evidence-based effective and efficient adaptive interventions. The application of SMART designs requires knowledge of its components, implementation, and analysis.

Professor Kidwell opened the presentation by discussing why researchers would use SMART designs, when adaptive interventions are useful, and questions to consider during the development process. SMART randomization allows for valid causal inferences about treatment effectiveness without making unverifiable assumptions and provides a baseline for identifying important individualization variables at each step. Guidelines to consider a SMART

Kidwell explained that adaptive interventions are sequences of individually tailored decision rules that specify whether, how, and/or when to alter the intensity-type dose or delivery of an intervention at critical decision points along the course of care or along the implementation framework.

“We’re trying to provide a guideline or formula for treatment or implementation, but these need to be evidence based, it can’t just be based on experience,” noted Kidwell. “We really want to provide rigorous evidence behind these adaptive interventions; our goal here is just to operationalize the sequential decision making to improve clinical practice.”

Following Kidwell’s presentation, Prof. Windsor discussed conducting community-based participatory research and how that adds a twist in how to do this work. Providing examples of these research projects, Windsor discussed how SMARTs were applied to research designs and shared what that might look like. Attendees had the opportunity to participate in a Q&A session following the presentation.

Connect with IHSI

The BERD team offers expert biostatistical consulting and analysis services in support of health-related research. Contact for assistance with designing studies and enhancing data collection, management, and analysis for health-related research projects.

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