SMART trials

When you work out, do you drop the pounds or get so hungry you only gain more? Are you one of those people who would benefit from a protein-rich diet, or should you cut carbs instead? Maybe you should add vegetables and other healthy options?

Weight-loss researchers, like all good scientists, prefer to tackle these questions one at a time. But Drew Sayer, Ph.D., wants answers more quickly than that. "I'm moving my research into what I would call more of a pragmatic space," said Sayer, assistant professor in the Department of Nutrition Sciences.

Sayer is a pioneer in the field of SMART trials for weight-loss research. Sequential multiple-assignment, randomized trials "bridge the translational gap between traditional clinical research and implementation practice research," Sayer said. "If you go in for obesity counseling and after four to six weeks you are not improving, your nutritionist would say, 'Let's try something else.' That's not what happens in a typical research study. You would be randomized to intervention A or intervention B and stay with it throughout. A SMART design builds in a predetermined timepoint where we identify participants as responders or non-responders. The responders keep going and the non-responders are randomized to a second set of interventions."

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