N-of-1 trials

Biomed Central Family Practice has published an article considering the utility of n-of-1 trials in determining the best management practices for individual patients (full citation: Wegman AC, van der Windt DA, Stalman WA, de Vries TP. Conducting research in individual patients: lessons learnt from two series of N-of-1 trials. BMC Fam Pract. 2006 Sep 19;7(1):54). An n-of-1 trial is basically a randomized crossover trial in an individual patient, to compare two different treatments or treatment and placeboo, to gauge the most effective strategy in that particular patient.

This research design has also been receiving some attention lately for potential application in evaluating complementary and alternative medicine interventions.

Additional material:
- Bandolier definition
- NIH Interactive Textbook on Clinical Symptom Research: Ch. 6: Within-patient studies: crossover trials and n-of-1 studies
- Mahon J, Laupacis A, Donner A, Wood T. Randomised study of n of 1 trials versus standard practice. BMJ. 1996 Apr 27;312(7038):1069-74.
- example trial from clinicaltrials.gov: Randomized Trial Comparing N of 1 Trials to Standard Practice to Improve Adherence to Statins in Patients With Diabetes
- a quick PubMed search for more examples and discussion of this research design.