Salvato in:
| Autori principali: | , , , , , |
|---|---|
| Natura: | Preprint |
| Pubblicazione: |
2025
|
| Soggetti: | |
| Accesso online: | https://arxiv.org/abs/2505.00822 |
| Tags: |
Aggiungi Tag
Nessun Tag, puoi essere il primo ad aggiungerne!!
|
Sommario:
- A clustered adaptive intervention (cAI) is a pre-specified sequence of decision rules that guides practitioners on how best - and based on which measures - to tailor cluster-level intervention to improve outcomes at the level of individuals within the clusters. A clustered sequential multiple assignment randomized trial (cSMART) is a type of trial that is used to inform the empirical development of a cAI. The most common type of secondary aim in a cSMART focuses on assessing causal effect moderation by candidate tailoring variables. We introduce a clustered Q-learning framework with the M-out-of-N Cluster Bootstrap using data from a cSMART to evaluate whether a set of candidate tailoring variables may be useful in defining an optimal cAI. This approach could construct confidence intervals (CI) with near-nominal coverage to assess parameters indexing the causal effect moderation function. Specifically, it allows reliable inferences concerning the utility of candidate tailoring variables in constructing a cAI that maximizes a mean end-of-study outcome even when "non-regularity", a well-known challenge exists. Simulations demonstrate the numerical performance of the proposed method across varying non-regularity conditions and investigate the impact of varying number of clusters and intra-cluster correlation coefficient on CI coverage. Methods are applied on ADEPT dataset to inform the construction of a clinic-level cAI for improving evidence-based practice in treating mood disorders.