Volume 35, Issue 6
Research Article

Design of sequentially randomized trials for testing adaptive treatment strategies

Semhar B. Ogbagaber

Corresponding Author

Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, 15260 U.S.A.

Correspondence to: Semhar B. Ogbagaber, Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15260, U.S.A.

E‐mail: sbo8@pitt.edu

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Jordan Karp

Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213 U.S.A.

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Abdus S. Wahed

Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, 15260 U.S.A.

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First published: 27 September 2015
Citations: 9

Abstract

An adaptive treatment strategy (ATS) is an outcome‐guided algorithm that allows personalized treatment of complex diseases based on patients' disease status and treatment history. Conditions such as AIDS, depression, and cancer usually require several stages of treatment because of the chronic, multifactorial nature of illness progression and management. Sequential multiple assignment randomized (SMAR) designs permit simultaneous inference about multiple ATSs, where patients are sequentially randomized to treatments at different stages depending upon response status. The purpose of the article is to develop a sample size formula to ensure adequate power for comparing two or more ATSs. Based on a Wald‐type statistic for comparing multiple ATSs with a continuous endpoint, we develop a sample size formula and test it through simulation studies. We show via simulation that the proposed sample size formula maintains the nominal power. The proposed sample size formula is not applicable to designs with time‐to‐event endpoints but the formula will be useful for practitioners while designing SMAR trials to compare adaptive treatment strategies. Copyright © 2015 John Wiley & Sons, Ltd.

Number of times cited according to CrossRef: 9

  • Comparing adaptive interventions under a general sequential multiple assignment randomized trial design via multiple comparisons with the best, Journal of Statistical Planning and Inference, 10.1016/j.jspi.2020.06.008, 211, (143-153), (2021).
  • Sequential Multiple Assignment Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART COMPASS): Design Considerations, Statistics in Biopharmaceutical Research, 10.1080/19466315.2020.1822206, (1-17), (2020).
  • A gate-keeping test for selecting adaptive interventions under general designs of sequential multiple assignment randomized trials, Contemporary Clinical Trials, 10.1016/j.cct.2019.105830, 85, (105830), (2019).
  • Sample size considerations for comparing dynamic treatment regimens in a sequential multiple-assignment randomized trial with a continuous longitudinal outcome, Statistical Methods in Medical Research, 10.1177/0962280219877520, (096228021987752), (2019).
  • Unmet Needs and Challenges in Clinical Research of Intracerebral Hemorrhage, Stroke, 10.1161/STROKEAHA.117.019541, 49, 5, (1299-1307), (2018).
  • Power analysis in a SMART design: sample size estimation for determining the best embedded dynamic treatment regime, Biostatistics, 10.1093/biostatistics/kxy064, (2018).
  • Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations, American Journal of Preventive Medicine, 10.1016/j.amepre.2016.09.011, 52, 1, (115-124), (2017).
  • Design and analysis considerations for comparing dynamic treatment regimens with binary outcomes from sequential multiple assignment randomized trials, Journal of Applied Statistics, 10.1080/02664763.2017.1386773, (1-24), (2017).
  • Clinical Perspectives on Targeting Therapies for Personalized Medicine, Personalized Medicine, 10.1016/bs.apcsb.2015.11.003, (79-114), (2016).

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