Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS)

Scott R. Evans; Dean Follmann; Ying Liu; Thomas Holland; Sarah B. Doernberg; Nadine Rouphael; Toshimitsu Hamasaki; Yunyun Jiang; Judith J. Lok; Thuy Tien T. Tran; Anthony D. Harris; Vance G. Fowler; Helen Boucher; Barry N. Kreiswirth; Robert A. Bonomo; David Van Duin; David L. Paterson; Henry Chambers

doi:10.1093/cid/ciy912

Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS)

Scott R. Evans
, Dean Follmann
, Ying Liu
, Thomas Holland
, Sarah B. Doernberg
, Nadine Rouphael
, Toshimitsu Hamasaki
, Yunyun Jiang
, Judith J. Lok
, Thuy Tien T. Tran
, Anthony D. Harris
, Vance G. Fowler
, Helen Boucher
, Barry N. Kreiswirth
, Robert A. Bonomo
, David Van Duin
, David L. Paterson
, Henry Chambers

George Washington University
National Institutes of Health
Biogen IDEC
Duke University
University of California at San Francisco
Emory University
National Cerebral and Cardiovascular Center
Boston University
University of Maryland, Baltimore
Tufts Medical Center
Case Western Reserve University
University of North Carolina at Chapel Hill
University of Queensland

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Patient management is not based on a single decision. Rather, it is dynamic: Based on a sequence of decisions, with therapeutic adjustments made over time. Adjustments are personalized: Tailored to individual patients as new information becomes available. However, strategies allowing for such adjustments are infrequently studied. Traditional antibiotic trials are often nonpragmatic, comparing drugs for definitive therapy when drug susceptibilities are known. COMparing Personalized Antibiotic StrategieS (COMPASS) is a trial design that compares strategies consistent with clinical practice. Strategies are decision rules that guide empiric and definitive therapy decisions. Sequential, multiple-assignment, randomized (SMART) COMPASS allows evaluation when there are multiple, definitive therapy options. SMART COMPASS is pragmatic, mirroring clinical, antibiotic-treatment decision-making and addressing the most relevant issue for treating patients: Identification of the patient-management strategy that optimizes the ultimate patient outcomes. SMART COMPASS is valuable in the setting of antibiotic resistance, when therapeutic adjustments may be necessary due to resistance.

Original language	English
Pages (from-to)	1961-1967
Number of pages	7
Journal	Clinical Infectious Diseases
Volume	68
Issue number	11
DOIs	https://doi.org/10.1093/cid/ciy912
State	Published - 17 May 2019

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Pragmatic Trial
Sequential Randomization
Strategy

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10.1093/cid/ciy912

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Evans, S. R., Follmann, D., Liu, Y., Holland, T., Doernberg, S. B., Rouphael, N., Hamasaki, T., Jiang, Y., Lok, J. J., Tran, T. T. T., Harris, A. D., Fowler, V. G., Boucher, H., Kreiswirth, B. N., Bonomo, R. A., Van Duin, D., Paterson, D. L., & Chambers, H. (2019). Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS). Clinical Infectious Diseases, 68(11), 1961-1967. https://doi.org/10.1093/cid/ciy912

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title = "Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS)",

abstract = "Patient management is not based on a single decision. Rather, it is dynamic: Based on a sequence of decisions, with therapeutic adjustments made over time. Adjustments are personalized: Tailored to individual patients as new information becomes available. However, strategies allowing for such adjustments are infrequently studied. Traditional antibiotic trials are often nonpragmatic, comparing drugs for definitive therapy when drug susceptibilities are known. COMparing Personalized Antibiotic StrategieS (COMPASS) is a trial design that compares strategies consistent with clinical practice. Strategies are decision rules that guide empiric and definitive therapy decisions. Sequential, multiple-assignment, randomized (SMART) COMPASS allows evaluation when there are multiple, definitive therapy options. SMART COMPASS is pragmatic, mirroring clinical, antibiotic-treatment decision-making and addressing the most relevant issue for treating patients: Identification of the patient-management strategy that optimizes the ultimate patient outcomes. SMART COMPASS is valuable in the setting of antibiotic resistance, when therapeutic adjustments may be necessary due to resistance.",

keywords = "Pragmatic Trial, Sequential Randomization, Strategy",

author = "Evans, \{Scott R.\} and Dean Follmann and Ying Liu and Thomas Holland and Doernberg, \{Sarah B.\} and Nadine Rouphael and Toshimitsu Hamasaki and Yunyun Jiang and Lok, \{Judith J.\} and Tran, \{Thuy Tien T.\} and Harris, \{Anthony D.\} and Fowler, \{Vance G.\} and Helen Boucher and Kreiswirth, \{Barry N.\} and Bonomo, \{Robert A.\} and \{Van Duin\}, David and Paterson, \{David L.\} and Henry Chambers",

year = "2019",

month = may,

day = "17",

doi = "10.1093/cid/ciy912",

language = "English",

volume = "68",

pages = "1961--1967",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

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Evans, SR, Follmann, D, Liu, Y, Holland, T, Doernberg, SB, Rouphael, N, Hamasaki, T, Jiang, Y, Lok, JJ, Tran, TTT, Harris, AD, Fowler, VG, Boucher, H, Kreiswirth, BN, Bonomo, RA, Van Duin, D, Paterson, DL & Chambers, H 2019, 'Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS)', Clinical Infectious Diseases, vol. 68, no. 11, pp. 1961-1967. https://doi.org/10.1093/cid/ciy912

TY - JOUR

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AU - Evans, Scott R.

AU - Follmann, Dean

AU - Liu, Ying

AU - Holland, Thomas

AU - Doernberg, Sarah B.

AU - Rouphael, Nadine

AU - Hamasaki, Toshimitsu

AU - Jiang, Yunyun

AU - Lok, Judith J.

AU - Tran, Thuy Tien T.

AU - Harris, Anthony D.

AU - Fowler, Vance G.

AU - Boucher, Helen

AU - Kreiswirth, Barry N.

AU - Bonomo, Robert A.

AU - Van Duin, David

AU - Paterson, David L.

AU - Chambers, Henry

PY - 2019/5/17

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N2 - Patient management is not based on a single decision. Rather, it is dynamic: Based on a sequence of decisions, with therapeutic adjustments made over time. Adjustments are personalized: Tailored to individual patients as new information becomes available. However, strategies allowing for such adjustments are infrequently studied. Traditional antibiotic trials are often nonpragmatic, comparing drugs for definitive therapy when drug susceptibilities are known. COMparing Personalized Antibiotic StrategieS (COMPASS) is a trial design that compares strategies consistent with clinical practice. Strategies are decision rules that guide empiric and definitive therapy decisions. Sequential, multiple-assignment, randomized (SMART) COMPASS allows evaluation when there are multiple, definitive therapy options. SMART COMPASS is pragmatic, mirroring clinical, antibiotic-treatment decision-making and addressing the most relevant issue for treating patients: Identification of the patient-management strategy that optimizes the ultimate patient outcomes. SMART COMPASS is valuable in the setting of antibiotic resistance, when therapeutic adjustments may be necessary due to resistance.

AB - Patient management is not based on a single decision. Rather, it is dynamic: Based on a sequence of decisions, with therapeutic adjustments made over time. Adjustments are personalized: Tailored to individual patients as new information becomes available. However, strategies allowing for such adjustments are infrequently studied. Traditional antibiotic trials are often nonpragmatic, comparing drugs for definitive therapy when drug susceptibilities are known. COMparing Personalized Antibiotic StrategieS (COMPASS) is a trial design that compares strategies consistent with clinical practice. Strategies are decision rules that guide empiric and definitive therapy decisions. Sequential, multiple-assignment, randomized (SMART) COMPASS allows evaluation when there are multiple, definitive therapy options. SMART COMPASS is pragmatic, mirroring clinical, antibiotic-treatment decision-making and addressing the most relevant issue for treating patients: Identification of the patient-management strategy that optimizes the ultimate patient outcomes. SMART COMPASS is valuable in the setting of antibiotic resistance, when therapeutic adjustments may be necessary due to resistance.

KW - Pragmatic Trial

KW - Sequential Randomization

KW - Strategy

UR - https://www.scopus.com/pages/publications/85066828998

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DO - 10.1093/cid/ciy912

M3 - Article

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AN - SCOPUS:85066828998

SN - 1058-4838

VL - 68

SP - 1961

EP - 1967

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 11

ER -

Sequential, Multiple-Assignment, Randomized Trials for COMparing Personalized Antibiotic StrategieS (SMART-COMPASS)

Abstract

UN SDGs

Keywords

Access to Document

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