ArticleArchives of internal medicine2008
N-of-1 trials of expensive biological therapies: a third way?
Article in Archives of internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- The N-of-1 Trials and where to use them in Rheumatology.Mediterranean journal of rheumatology · 2025Review
- A Useful and Sustainable Role for N-of-1 Trials in the Healthcare Ecosystem.Clinical pharmacology and therapeutics · 2022Review
- Conduct and Implementation of Personalized Trials in Research and Practice.Harvard data science review · 2022Article
- Issues in assessing products for the treatment of hemophilia - the intersection between efficacy, economics, and ethics.Journal of blood medicine · 2015Article
- New methods for determining comparative effectiveness in rheumatoid arthritis.Current opinion in rheumatology · 2013Review
- Bayesian credible intervals for binomial proportions in a single patient trial.Statistical methods in medical research · 2010Article
- Acrylamine-induced autoimmune phenomena.Clinical rheumatology · 2010Article
- What ever happened to N-of-1 trials? Insiders' perspectives and a look to the future.The Milbank quarterly · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
In developing policies for use of expensive agents, such as those used for the treatment of rheumatoid arthritis, managed care organizations have invoked "stepped care," in which physicians and patients must first try more established and less costly agents. N-of-1 clinical trials are multiple crossover trials in a single patient. In this cost-minimization analysis, we show that offering patients with rheumatoid arthritis the opportunity to participate in an n-of-1 trial comparing methotrexate with etanercept could save costs relative to open access while preserving clinical freedom relative to mandatory stepped care. In the primary model, the n-of-1 trial option was 15% more expensive than stepped care but 47% cheaper than open access to etanercept. More research is needed on the acceptability, safety, and generalizability of this promising approach.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.