An N-of-1 Trial as an Aid to Decision-Making Prior to Implanting a Permanent Spinal Cord Stimulator

Abstract

We encourage clinicians to perform an N-of-1 trial in every patient before implanting permanent electrodes for SCS.

N-of-1 Randomized Trials to Assess the Efficacy of Gabapentin for Chronic Neuropathic Pain

“…The results of a series of n‐of‐1 trials can also be meta‐analyzed to give an estimate of response at a population level [5]. In the treatment of neuropathic pain, although there is a case report of an n‐of‐1 trial of a spinal cord stimulator [6], we have been unable to find any publications describing the use of n‐of‐1 trial methodology for the use of gabapentin.…”

Peri-ictal behavioural change in people with an intellectual disability

“…Single subject research designs have a place in medical research, for example Nof1 trials enable a single participant to undergo periods of comparative treatment (Cepeda et al, 2008;Guyatt et al, 1990). They empower the patient, improve doctor patient communication and increase clinician confidence in treatment options (Guyatt et al, 1990;Nickles et al, 2005).…”

When Bad Evidence Happens to Good Treatments

“…In that context, N-of-1 trials should be considered as a means to judge for an individual patient whether a contemplated therapy should be carried out. 87 To ask "does the treatment work?" or to state "it doesn't differ from placebo" are disingenuous when directed toward pain treatments in the abstract, divorced from assessment of individual patients.…”