What is the difference between MOST and SMART? How are they related?


MOST is a general framework for development, optimization, and evaluation of all types of interventions.

SMART is an acronym for “sequential multiple-assignment randomized trial.” The SMART is an optimization trial design that has been devised for use in optimization of certain types of interventions. So, the SMART is one of a number of different experimental designs that can be used in MOST. In other words, the SMART is one part of the MOST framework.

Confusion on this point probably stems from the very early days of the development of intervention optimization methods, when Linda Collins and Susan Murphy co-authored an article in which they treated MOST and SMART as separate. Believe it or not, at that time neither one of them saw the big picture of how everything fit together (one example of how science, even quantitative methods, can be messy). This remains a highly-cited article, so it has been difficult to correct the misperception we caused.

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Further Learning

Whether you are looking for additional support as you prepare a grant proposal involving MOST or practical information helpful in managing your optimization trial, this section provides resources for a deeper dive into intervention optimization.

REDCap with Most

The goal of this manual is to show how one might setup a REDCap project to support a research study with multiple conditions, such as factorial experiments common in the Multiphase Optimization Strategy (MOST) framework.

Informal introduction to factorial experimental designs

The purpose of this page is to clarify some concepts, notation, and terminology related to factorial experimental designs, and to compare and contrast factorial experiments to randomized controlled trials (RCTs). A more in-depth introduction can...


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