Incorporating Participants' Welfare into Sequential Multiple Assignment Randomized Trials
将参与者福利纳入序贯多重分配随机试验AI 解读 ↓
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AI 根据所提供的论文材料归类：摘要围绕多阶段随机试验设计、治疗分配和动态治疗规则的因果评价展开。
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将参与者福利纳入序贯多重分配随机试验
- 研究问题
- 序贯多重分配随机试验如何纳入参与者的治疗偏好和预测疗效，在改善试验内福利的同时保留构建最优动态治疗规则的能力？
- 方法与思路
- 作者基于 Experiment-as-Market 框架提出 SMART-EXAM，将偏好与预测治疗效应纳入多阶段随机分配，并开展比较及实例演示。
- 材料陈述的贡献
- 摘要称在实验参数适当设定时，新设计可提高参与者福利并保持构建最优动态治疗规则的能力，以儿童 ADHD 试验数据说明潜力。
- 阅读关注点
- 应核对福利指标、随机分配概率与参数选择、疗效预测如何训练，以及设计改变后动态治疗规则估计和比较的有效性。
- 阅读边界
- 这是 arXiv 预印本，同行评审及期刊接收均未核实；摘要未说明适当参数的范围，也未证明招募、脱落或外部效度改善。
原文摘要
Dynamic treatment regimes (DTRs) are sequences of decision rules that recommend treatments based on patients' time-varying clinical conditions. The sequential multiple assignment randomized trial (SMART) is an experimental design that can provide high-quality evidence for constructing optimal DTRs. In a conventional SMART, participants are randomized to available treatments at multiple stages with balanced randomization probabilities. Despite its relative simplicity of implementation and desirable performance in comparing embedded DTRs, the conventional SMART faces inevitable ethical issues including assigning many participants to the empirically inferior treatment or the treatment they dislike, which might slow down the recruitment procedure and lead to higher attrition rates, ultimately leading to poor internal and external validities of the trial results. In this context, we propose a SMART under the Experiment-as-Market framework (SMART-EXAM), a novel SMART design that holds the potential to improve participants' welfare by incorporating their preferences and predicted treatment effects into the randomization procedure. We describe the steps of conducting a SMART-EXAM and evaluate its performance compared to the conventional SMART. The results indicate that the SMART-EXAM can improve the welfare of the participants enrolled in the trial, while also achieving a desirable ability to construct an optimal DTR when the experimental parameters are suitably specified. We finally illustrate the practical potential of the SMART-EXAM design using data from a SMART for children with attention-deficit/hyperactivity disorder (ADHD).