Why are there repeated randomizations in an MRT?


Another way to ask this question is “What can you learn from the repeated randomizations that are part of an MRT?” The primary rationale for randomization is that it enhances balance in the distribution of unobserved factors across groups assigned to different treatments. This enhances the ability to assess causal effects; that is, randomization reduces alternative explanations for why the group assigned one treatment has improved outcomes as compared to a group assigned an alternate treatment. The repeated randomizations in an MRT enhance balance in the distribution of unobserved factors between participants/decision points assigned to different intervention options. Thus MRTs can provide data to help answer questions including whether or not delivering an intervention component has the desired effect on the targeted proximal outcome, and whether this effect varies with time, prior dose and the current context of the individual.



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