IDEAS home Printed from https://ideas.repec.org/p/eti/dpaper/23081.html
   My bibliography  Save this paper

SMART-EXAM: Incorporating Participants' Welfare into Sequential Multiple Assignment Randomized Trials

Author

Listed:
  • Xinru WANG
  • Nina DELIU
  • NARITA Yusuke
  • Bibhas CHAKRABORTY

Abstract

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).

Suggested Citation

  • Xinru WANG & Nina DELIU & NARITA Yusuke & Bibhas CHAKRABORTY, 2023. "SMART-EXAM: Incorporating Participants' Welfare into Sequential Multiple Assignment Randomized Trials," Discussion papers 23081, Research Institute of Economy, Trade and Industry (RIETI).
    • Handle: RePEc:eti:dpaper:23081
    as

    Download full text from publisher

    File URL: https://www.rieti.go.jp/jp/publications/dp/23e081.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Brian J. Gaines & James H. Kuklinski, 2011. "Experimental Estimation of Heterogeneous Treatment Effects Related to Self‐Selection," American Journal of Political Science, John Wiley & Sons, vol. 55(3), pages 724-736, July.
    2. Bibhas Chakraborty & Eric B. Laber & Yingqi Zhao, 2013. "Inference for Optimal Dynamic Treatment Regimes Using an Adaptive m-Out-of-n Bootstrap Scheme," Biometrics, The International Biometric Society, vol. 69(3), pages 714-723, September.
    3. Michael C Knaus & Michael Lechner & Anthony Strittmatter, 2021. "Machine learning estimation of heterogeneous causal effects: Empirical Monte Carlo evidence," The Econometrics Journal, Royal Economic Society, vol. 24(1), pages 134-161.
    4. Lu Wang & Andrea Rotnitzky & Xihong Lin & Randall E. Millikan & Peter F. Thall, 2012. "Evaluation of Viable Dynamic Treatment Regimes in a Sequentially Randomized Trial of Advanced Prostate Cancer," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 107(498), pages 493-508, June.
    5. Ying Kuen Cheung & Bibhas Chakraborty & Karina W. Davidson, 2015. "Sequential multiple assignment randomized trial (SMART) with adaptive randomization for quality improvement in depression treatment program," Biometrics, The International Biometric Society, vol. 71(2), pages 450-459, June.
    6. Liwen Wu & Junyao Wang & Abdus S. Wahed, 2023. "Interim monitoring in sequential multiple assignment randomized trials," Biometrics, The International Biometric Society, vol. 79(1), pages 368-380, March.
    7. Dean Knox & Teppei Yamamoto & Matthew A. Baum & Adam J. Berinsky, 2019. "Design, Identification, and Sensitivity Analysis for Patient Preference Trials," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 114(528), pages 1532-1546, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Michael P. Wallace & Erica E. M. Moodie, 2015. "Doubly‐robust dynamic treatment regimen estimation via weighted least squares," Biometrics, The International Biometric Society, vol. 71(3), pages 636-644, September.
    2. Yebin Tao & Lu Wang, 2017. "Adaptive contrast weighted learning for multi-stage multi-treatment decision-making," Biometrics, The International Biometric Society, vol. 73(1), pages 145-155, March.
    3. Davide Viviano & Jelena Bradic, 2019. "Synthetic learner: model-free inference on treatments over time," Papers 1904.01490, arXiv.org, revised Aug 2022.
    4. Daniel Goller, 2023. "Analysing a built-in advantage in asymmetric darts contests using causal machine learning," Annals of Operations Research, Springer, vol. 325(1), pages 649-679, June.
    5. Zeyu Bian & Erica E. M. Moodie & Susan M. Shortreed & Sahir Bhatnagar, 2023. "Variable selection in regression‐based estimation of dynamic treatment regimes," Biometrics, The International Biometric Society, vol. 79(2), pages 988-999, June.
    6. Thomas A. Murray & Peter F. Thall & Ying Yuan & Sarah McAvoy & Daniel R. Gomez, 2017. "Robust Treatment Comparison Based on Utilities of Semi-Competing Risks in Non-Small-Cell Lung Cancer," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 112(517), pages 11-23, January.
    7. Michael C Knaus, 2022. "Double machine learning-based programme evaluation under unconfoundedness [Econometric methods for program evaluation]," The Econometrics Journal, Royal Economic Society, vol. 25(3), pages 602-627.
    8. Denis Fougère & Nicolas Jacquemet, 2020. "Policy Evaluation Using Causal Inference Methods," SciencePo Working papers Main hal-03455978, HAL.
    9. Humphreys, Macartan & Scacco, Alexandra, 2020. "The aggregation challenge," World Development, Elsevier, vol. 127(C).
    10. Cockx, Bart & Lechner, Michael & Bollens, Joost, 2023. "Priority to unemployed immigrants? A causal machine learning evaluation of training in Belgium," Labour Economics, Elsevier, vol. 80(C).
    11. Daniel Jacob, 2021. "CATE meets ML -- The Conditional Average Treatment Effect and Machine Learning," Papers 2104.09935, arXiv.org, revised Apr 2021.
    12. Daniel Boller & Michael Lechner & Gabriel Okasa, 2021. "The Effect of Sport in Online Dating: Evidence from Causal Machine Learning," Papers 2104.04601, arXiv.org.
    13. Subhankar Chattopadhyay & Raju Maiti & Samarjit Das & Atanu Biswas, 2022. "Change‐point analysis through integer‐valued autoregressive process with application to some COVID‐19 data," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 76(1), pages 4-34, February.
    14. Phillip Heiler & Michael C. Knaus, 2021. "Effect or Treatment Heterogeneity? Policy Evaluation with Aggregated and Disaggregated Treatments," Papers 2110.01427, arXiv.org, revised Aug 2023.
    15. Goller, Daniel & Lechner, Michael & Moczall, Andreas & Wolff, Joachim, 2020. "Does the estimation of the propensity score by machine learning improve matching estimation? The case of Germany's programmes for long term unemployed," Labour Economics, Elsevier, vol. 65(C).
    16. Verbeke, Wouter & Olaya, Diego & Guerry, Marie-Anne & Van Belle, Jente, 2023. "To do or not to do? Cost-sensitive causal classification with individual treatment effect estimates," European Journal of Operational Research, Elsevier, vol. 305(2), pages 838-852.
    17. Yaoyao Xu & Menggang Yu & Ying‐Qi Zhao & Quefeng Li & Sijian Wang & Jun Shao, 2015. "Regularized outcome weighted subgroup identification for differential treatment effects," Biometrics, The International Biometric Society, vol. 71(3), pages 645-653, September.
    18. Jincheng Shen & Lu Wang & Jeremy M. G. Taylor, 2017. "Estimation of the optimal regime in treatment of prostate cancer recurrence from observational data using flexible weighting models," Biometrics, The International Biometric Society, vol. 73(2), pages 635-645, June.
    19. Daniel Goller & Tamara Harrer & Michael Lechner & Joachim Wolff, 2021. "Active labour market policies for the long-term unemployed: New evidence from causal machine learning," Papers 2106.10141, arXiv.org, revised May 2023.
    20. Patrick Rehill & Nicholas Biddle, 2022. "Policy learning for many outcomes of interest: Combining optimal policy trees with multi-objective Bayesian optimisation," Papers 2212.06312, arXiv.org, revised Oct 2023.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eti:dpaper:23081. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: TANIMOTO, Toko (email available below). General contact details of provider: https://edirc.repec.org/data/rietijp.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.