Getting the right treatment to the right patient is a frustrating goal in mental health: treatment is a trial-and-error endeavor, often yielding disappointing outcomes. Why? Traditional randomized clinical trials (RCTs) do not adequately capture the dynamic complexity of the brain and behavior during treatment. Our increasing understanding of the pathophysiology of mental disorders will not translate to legitimate movement toward precision medicine unless we overcome 3 limitations of RCTs methods: (1) measuring only static baseline characteristics is unlikely to identify treatment responders, (2) a treatment that does not adapt to the individual patient is unlikely to be optimal, and (3) infrequently administered measures do not have the precision to predict or measure outcomes.

为正确的患者提供正确的治疗是心理健康的一个令人沮丧的目标：治疗是一个反复试验的尝试，通常会产生令人失望的结果。为什么？传统的随机临床试验（RCT）无法充分捕捉治疗过程中大脑的动态复杂性和行为。除非我们克服了RCTs方法的3种局限性，否则我们对精神障碍的病理生理学的日益了解将不会转化为向精密医学的合法发展：（1）仅测量静态基线特征不可能确定治疗反应者，（2）不能治疗的患者适应个体患者的方法不太可能是最佳的；（3）不经常使用的措施不具有预测或衡量结果的精确度。