Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part B Therapy
Chapter 9.5. N-of-1 Randomized Controlled Trials
Gordon Guyatt, Roman Jaeschke, Thomas McGinn
N-of-1 Randomized Controlled Trials: Introduction
Topics Discussed:
n-of-1 controlled trials, randomized controlled trials
Excerpt:
"Clinicians should use the results of randomized
controlled trials (RCTs) of groups of
patients to guide their clinical practice. When deciding which management approach
will be best for an individual patient, however, clinicians cannot
always rely on the results of RCTs. An RCT addressing
the particular issue may not be available; for example, some conditions
are so rare that randomized trials are not feasible. Furthermore,
even when a relevant RCT generates a clear answer, its
result may not apply to an individual patient. First, if the patient
is very different from trial participants, the trial results may
not be applicable to that patient (see Chapter 11.1, Applying Results to Individual Patients). Second, regardless
of the overall trial results, some similar patients may benefit
from a given therapy, whereas others receive no benefit. Clinicians
may have particularly strong reservations about applying RCT results
to individuals when results have shown small treatment
effects of questionable importance...."
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