An adaptive treatment strategy (ATS) is a rule for adapting a treatment plan to a patient's history of previous treatments and the response to those treatments. The ongoing management of chronic disease defines an ATS, which may be implicit and hidden or explicit and well-specified. The ATS is characterized by the use of intermediate, early markers of response to dynamically alter treatment decisions, in order to achieve a favorable ultimate outcome. We illustrate the ATS concept and describe how the effect of initial treatment decisions depends on the performance of subsequent decisions at later stages. We show how to compare two or more ATSs, or to determine an optimal ATS, using a sequential multiple assignment randomized (SMAR) trial. Designers of clinical trials might find the ATS concept useful in improving the efficiency and ecological relevance of clinical trials.

中文翻译：

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慢性病的适应性治疗策略。

适应性治疗策略 (ATS) 是使治疗计划适应患者既往治疗史和对这些治疗的反应的规则。慢性病的持续管理定义了 ATS，它可能是隐含的和隐藏的，也可能是明确的和明确规定的。ATS 的特点是使用中间的、早期的反应标志物来动态改变治疗决策，以实现有利的最终结果。我们阐述了 ATS 概念并描述了初始治疗决策的影响如何取决于后期决策的表现。我们展示了如何使用顺序多重分配随机 (SMAR) 试验比较两个或多个 ATS，或确定最佳 ATS。