N of 1 trial

Question 1

When is a N of 1 trial carried out?

Answer 1

• when a clinician is uncertain whether a treatment that has not yet been started will work or whether there is benefit, or whether the right dose has been reached
• may also be when there may be adverse effects
• may also be where the patient has insisted on taking treatment that is harmful

Question 2

When is an N of 1 trial feasible?

Answer 2

• patient is keen
• treatment has rapid onset and termination of action
• only symptom control must be possible not condition modification
• needs a pharmacist to help with blinding

Question 3

How to conduct an N-of-1 trial

Answer 3

• patient and doctor remain blind
• pharmacist delivers control and active drug in identical form
• each cycle is randomly determined by a third party
• regular measurements are done
• often stopped when a strong pattern has emerged
• the data is then analysed to see which intervention fared better

Question 4

Generalisation

Answer 4

-not possible