title: Testing patient targeted therapies in patients with temporomandibular joint disorder with the arthrokinetic reflex: individual patient research.
abstract: Traditional research in the health sciences has involved control and experimental groups of patients, and descriptive and inferential statistical analyses performed on the measurements obtained from the samples in each group. As the novel model of translational healthcare, which integrates translational research and translational effectiveness, becomes increasingly established in modern contemporary medicine, healthcare continues to evolve into a model of care that is evidence-based, effectiveness-focused and patient-centered. Patient-centered care and patient-targeted therapies require the timely and critical development and validation of a new research paradigm, individual patient research (IPR), as opposed to the customary group research approach. Here, we propose a model of individual patient research to define and characterize the effectiveness of a novel therapeutic intervention for temporomandibular joint disorder. The intervention must be tailor-made for each individual patient, and the data from each patient must be analyzed individually. We propose that this endeavor is best achieved by means of an adaptive cluster randomized stepped wedge blinded controlled trial, because it permit individual patient outcomes research and analysis, ensures equipoise, and maintains adequate power. The patient targeted therapies section of the Journal of Translational Medicine must endeavor to facilitate the dissemination of studies that focus broadly on translational research for the ultimate benefit of individual patients.
authors.affiliation: Oral Biology & Medicine, Center for the Health Sciences UCLA, Los Angeles, USA.|Center for TMJ and Sleep Therapy, Glendora, CA, USA.|Evidence-Based Decisions Practice-Based Research Network (EBD-PBRN.org), Los Angeles, USA.
authors.forename: Garabed G
authors.initials: GG
authors.lastname: Demerjian
authors.affiliation: Oral Biology & Medicine, Center for the Health Sciences UCLA, Los Angeles, USA.|Center for TMJ and Sleep Therapy, Glendora, CA, USA.|Evidence-Based Decisions Practice-Based Research Network (EBD-PBRN.org), Los Angeles, USA.
authors.forename: Andre
authors.initials: A
authors.lastname: Barkhordarian
authors.affiliation: Oral Biology & Medicine, Center for the Health Sciences UCLA, Los Angeles, USA. fchiappelli@dentistry.ucla.edu.|Center for TMJ and Sleep Therapy, Glendora, CA, USA. fchiappelli@dentistry.ucla.edu.|Evidence-Based Decisions Practice-Based Research Network (EBD-PBRN.org), Los Angeles, USA. fchiappelli@dentistry.ucla.edu.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiappelli
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D008962:Models, Theoretical; D018802:Patient-Centered Care; D012018:Reflex; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology* / Q000628:therapy*; D057170:Translational Research, Biomedical
keywords: Adaptive cluster randomized stepped wedge blinded controlled trial; Arthrokinetic reflex; Comparative effectiveness research (CER); Individual patient research (IPR); Patient-targeted therapy; Temporomandibular joint disorder