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- Title
Interim monitoring in sequential multiple assignment randomized trials.
- Authors
Wu, Liwen; Wang, Junyao; Wahed, Abdus S.
- Abstract
A sequential multiple assignment randomized trial (SMART) facilitates the comparison of multiple adaptive treatment strategies (ATSs) simultaneously. Previous studies have established a framework to test the homogeneity of multiple ATSs by a global Wald test through inverse probability weighting. SMARTs are generally lengthier than classical clinical trials due to the sequential nature of treatment randomization in multiple stages. Thus, it would be beneficial to add interim analyses allowing for an early stop if overwhelming efficacy is observed. We introduce group sequential methods to SMARTs to facilitate interim monitoring based on the multivariate chi‐square distribution. Simulation studies demonstrate that the proposed interim monitoring in SMART (IM‐SMART) maintains the desired type I error and power with reduced expected sample size compared to the classical SMART. Finally, we illustrate our method by reanalyzing a SMART assessing the effects of cognitive behavioral and physical therapies in patients with knee osteoarthritis and comorbid subsyndromal depressive symptoms.
- Subjects
FALSE positive error; CHI-square distribution; COGNITIVE therapy; KNEE osteoarthritis; OPTIMAL stopping (Mathematical statistics)
- Publication
Biometrics, 2023, Vol 79, Issue 1, p368
- ISSN
0006-341X
- Publication type
Article
- DOI
10.1111/biom.13562