Addressing the Challenges and Reaping the Benefits of SMARTs

A Sequential Multiple Assignment Randomized Trial (SMART) is a novel clinical trial to construct and investigate dynamic treatment regimens (DTRs). In turn these DTRs can guide clinical practice and improve care. With the novelty of this design comes both excitement and trepidation. Both of these reactions are valid as the possibilities of scientific questions that can be assessed and the relevance of results of a SMART are exciting, but the design is not always appropriate and the new vocabulary, intricate-looking designs and possible additional infrastructure may discourage use. This talk will highlight a few SMARTs in the fields of mental health and oncology noting the different possible designs and aims. Furthermore, these SMARTs will be used to illustrate the challenges in design, implementation and analysis, as well as, the advantages of a SMART design compared to others.