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  • Finding Benefit in n-of-1 Trials (Letter)

    Author(s)
    McDonald, Suzanne
    McGree, James
    Bazzano, Lydia
    Griffith University Author(s)
    McDonald, Suzanne
    Year published
    2019
    Metadata
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    Abstract
    To the Editor We read with interest the recent article by Kravitz and colleagues1 describing a randomized clinical trial comparing n-of-1 trials with standard care for treatment of chronic musculoskeletal pain. The goal of the study was to establish the “benefits of participating in an n-of-1 trial, not to assess the superiority or inferiority of any particular treatment.”1(1369) However, there appears to be a disconnect between the study goal and the choice of outcomes, which were focused on pain interference scores across different treatment regimens. Therefore, the null results should be interpreted with respect to ...
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    To the Editor We read with interest the recent article by Kravitz and colleagues1 describing a randomized clinical trial comparing n-of-1 trials with standard care for treatment of chronic musculoskeletal pain. The goal of the study was to establish the “benefits of participating in an n-of-1 trial, not to assess the superiority or inferiority of any particular treatment.”1(1369) However, there appears to be a disconnect between the study goal and the choice of outcomes, which were focused on pain interference scores across different treatment regimens. Therefore, the null results should be interpreted with respect to treatment efficacy, not design. The n-of-1 participants who demonstrated a better response to 1 of 2 treatments were likely to experience improved pain outcomes as a result of continuing to receive the superior treatment. However, there was a high proportion (>75%) of n-of-1 participants who had no treatment superiority, and this may explain the trial’s findings.
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    Journal Title
    JAMA Internal Medicine
    Volume
    179
    Issue
    3
    DOI
    https://doi.org/10.1001/jamainternmed.2018.8382
    Subject
    Clinical sciences
    Science & Technology
    Life Sciences & Biomedicine
    Medicine, General & Internal
    General & Internal Medicine
    Publication URI
    http://hdl.handle.net/10072/411577
    Collection
    • Journal articles

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