A SMART design to optimize treatment strategies for patient and family caregiver outcomes.
Sequential multiple randomization trial (SMART) designs are experimental designs used to identify treatment strategies that maximize targeted health outcomes. SMART designs are receiving greater attention in nursing and other health disciplines to develop multicomponent interventions that are tailored to the patient's (or family caregiver's) needs and preferences. A SMART design resembles a traditional randomized controlled trial (RCT) design in that it scientifically examines intervention effects with randomization. However, the two designs address very different research inquiries. In this article, we compare traditional RCT designs and SMART designs, describe the adaptive treatment framework that underlies SMART designs and key features of SMART designs, and illustrate the application of a SMART design to develop an adaptive palliative care treatment to improve patient and caregiver outcomes.
Center for Nursing Excellence in Palliative Care, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. Electronic address: mi-kyung.song@emory.edu.
Mi-Kyung
MK
Song
Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA.
Annette
A
DeVito Dabbs
School of Nursing, University of Wisconsin-Madison, Madison, WI.
Sandra E
SE
Ward
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D022143:Family Nursing / Q000379:methods*; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015399:Nursing Research / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design
Intervention; Randomized trials; Research designs