Alla Sikorskii is a methodologist and statistician with nearly two decades of experience in health research. She has formal training in Statistics and Probability and a track record of successful productive collaboration with health researchers and clinicians She has built a program of research in symptom management and patient-reported outcomes (PROs) and design and evaluation of interventions to improve these outcomes among people with chronic conditions. Her contributions to PRO measurement and intervention research have been nationally and internationally recognized.
Dr. Sikorskii has designed numerous randomized controlled trials (RCTs) including procedures for screening, randomization, timing of longitudinal assessments, measurement of important confounders, and ways to control for them. Her most recent work is devoted to the advance from traditional RCTs that test fixed interventions to adaptive interventions tailored to individuals. This shift requires research that sequences interventions and creates decision rules for switching from one intervention to another based individuals’ demonstrated needs. When an intervention does not initially work, clinical logic is to either extend the timeframe or move to a more intensive intervention. This logic leads to multi-staged interventions, where the subsequent stage is individually tailored, based on the response to the previous intervention (stage). Currently, such clinical decisions are not be evidence-based. The sequential multiple assignment randomized trial (SMART) allows to build the evidence base for multi-staged interventions. Dr. Sikorskii is leading the applications of the SMART design to test sequences of supportive care interventions among people with chronic conditions. She is also applying advanced stochastic processes methods to identify individuals at risk for adverse quality of life outcomes and those in need for supportive care interventions based on biomarker data including electroencephalogram recordings.
Using SMART Design to Improve Symptom Management Strategies Among Cancer Patients.
The sequential multiple assignment randomized trial (SMART) will be used to provide a rigorous evidence base for multi-staged interventions, where each stage could be either reflexology delivered by a friend or family caregiver or meditative practices. Intervention sequences consisting of these two therapies will be compared on the outcomes of severity of fatigue and other symptoms using a sample of patients with solid tumors undergoing chemotherapy.
Implementing to sustain: Determining the minimum necessary intervention to maintain a postpartum depression prevention program (ROSE) in clinics providing prenatal services to low-income women
Using SMART design, this project will determine the minimum necessary implementation intervention necessary to sustain ROSE in 90 prenatal clinics serving low-income women in 6 U.S. states.