Department of Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller-Institute of Psychology, University of Göttingen, Kurze-Geismar-Str.1, 37073, Göttingen, Germany.
Adm Policy Ment Health. 2024 Sep;51(5):686-701. doi: 10.1007/s10488-023-01340-4. Epub 2024 Feb 5.
The route for the development, evaluation and dissemination of personalized psychological therapies is complex and challenging. In particular, the large sample sizes needed to provide adequately powered trials of newly-developed personalization approaches means that the traditional treatment development route is extremely inefficient. This paper outlines the promise of adaptive platform trials (APT) embedded within routine practice as a method to streamline development and testing of personalized psychological therapies, and close the gap to implementation in real-world settings. It focuses in particular on a recently-developed simplified APT design, the 'leapfrog' trial, illustrating via simulation how such a trial may proceed and the advantages it can bring, for example in terms of reduced sample sizes. Finally it discusses models of how such trials could be implemented in routine practice, including potential challenges and caveats, alongside a longer-term perspective on the development of personalized psychological treatments.
个性化心理疗法的开发、评估和传播途径复杂且具有挑战性。特别是，为新开发的个性化方法提供足够有力的试验所需的大样本量意味着传统的治疗开发途径效率极低。本文概述了在常规实践中嵌入适应性平台试验（APT）的前景，作为一种简化个性化心理疗法开发和测试的方法，并缩小与实际应用之间的差距。它特别关注最近开发的简化 APT 设计，即“跨越式”试验，通过模拟说明此类试验如何进行以及它可以带来的优势，例如在减少样本量方面。最后，它讨论了在常规实践中实施此类试验的模型，包括潜在的挑战和注意事项，以及对个性化心理治疗发展的更长期展望。
