Northwestern University

Mon 2:00 PM

Biostatistics Seminar

recurring see all events in this series

When: Monday, February 11, 2019
2:00 PM - 3:00 PM  

Where: 680 N. Lake Shore Drive, Stamer Conference room, Ste 1400, Chicago, IL 60611 map it

Audience: Faculty/Staff - Student - Post Docs/Docs - Graduate Students

Contact: Putri Kusumo   312.908.1718

Group: Department of Preventive Medicine

Category: Academic



Presentatation with a Candidate of the Division of Biostatistics / BCC Faculty Position

Hayley Belli, PhD

Postdoctoral Fellow
Division of Biostatistics
New York University Langone School of Medicine


Presentation Title:
Improving Patient Outcomes: Adaptive Stage Duration in a Sequential Multiple Assignment Randomized Trial (SMART)

Brief Abstract:
In the era of precision medicine, there is a clear need to design more patient-focused, pragmatic clinical trials. In this talk, I will introduce a statistical method for selecting individualized treatment duration in a Sequential Multiple Assignment Randomized Trial (SMART). In this type of adaptive design, patients move through a series of stages with the option to continue or switch interventions at the end of each stage based on treatment response. Over time, patients will be assigned to more effective interventions. However, under the standard SMART framework, the length of the treatment period is usually fixed, selected by investigators in advance (without much guiding data), and applied uniformly to all participants in the study. We address these shortcomings of SMARTs by introducing a likelihood-based method to determine when an individual patient should stay on a treatment or switch interventions prior to the stage end. This new methodology uses data and design principles to provide patients with treatment options that are advantageous both clinically and ethically, all within the rigorous, experimental framework of a randomized controlled trial. Following derivation, we illustrate the performance of this algorithm using data from the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) Study, a two-stage SMART design measuring the effectiveness of sertraline in patients with Major Depressive Disorder.

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