An N of 1 service: applying the scientific method in clinical practice.
The N of 1 service at our institution acts as a full referral service for clinicians who want a definitive answer to a difficult management question, and an instructional environment for clinicians who have more time and want to learn to run their own N of 1 RCT. The trial design is a double blind, randomized pair, multiple crossover. A number of methodologic issues are discussed, such as appropriateness of the patients problem to N of 1 trials, feasibility, types of measurement, such as clinical objective measurement and quality of life measurement, as well as timing of these measurements. The analysis issues include developing a reporting method which is statistically powerful and understandable to clinicians with little research background. Some of these issues have been well investigated and some have not.
Keller
J L
JL
Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario.
Guyatt
G H
GH
Roberts
R S
RS
Adachi
J D
JD
Rosenbloom
D
D
D002986:Clinical Trials as Topic; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D006801:Humans; D008499:Medical Records; D011897:Random Allocation; D012017:Referral and Consultation; D012107:Research Design