SMART Thinking: a Review of Recent Developments in Sequential Multiple Assignment Randomized Trials

With the increasing interest in personalized medicine, over the last decade, sequential multiple assignment randomized trials (SMARTs) have become a more common fixture of the clinical trial landscape. Primarily of use in the identification of dynamic treatment regimes, they have experienced a shift from the more complex designs of the past to the considerably streamlined versions seen today. In this review, we summarize their history, outline recent and ongoing examples, and discuss some of the important methodological developments for their design and implementation.