ArticleThe Milbank quarterly2008
What ever happened to N-of-1 trials? Insiders' perspectives and a look to the future.
Article in The Milbank quarterly, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
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
59 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Personalized (N-of-1) Trials for Depression: A Systematic Review.Journal of clinical psychopharmacology · 2018Pooled it
- N-of-1 trials in the clinical care of patients in developing countries: a systematic review.Trials · 2018Pooled it
- A Series of Personalized Melatonin Supplement Interventions for Poor Sleep: Feasibility Randomized Crossover Trial for Personalized N-of-1 Treatment.JMIR formative research · 2025Trial
- Treating Hypertension in Children WithPediatrics · 2019Trial
- A Randomized Placebo-ControlledCanadian journal of gastroenterology & hepatology · 2019Trial
- Effect of Mobile Device-Supported Single-Patient Multi-crossover Trials on Treatment of Chronic Musculoskeletal Pain: A Randomized Clinical Trial.JAMA internal medicine · 2018Trial
- Trial
- Pilot study of a pediatric metronomic 4-drug regimen.Oncotarget · 2011Trial
- Using N-of-1 trials to improve patient management and save costs.Journal of general internal medicine · 2010Trial
- Article
- Randomized Personalized Trial for Stress Management Compared to Standard of Care.Journal of personalized medicine · 2026Article
- Instrumental variable approach to estimating individual causal effects in N-of-1 trials: application to ISTOP study.Biostatistics (Oxford, England) · 2025Article
- Blueprint for clinical N-of-1 strategies with off-label precision treatments in monogenic epilepsies.Orphanet journal of rare diseases · 2025Review
- Feasibility Test of Personalized (N-of-1) Trials for Increasing Middle-Aged and Older Adults' Physical Activity.International journal of behavioral medicine · 2025Article
- Development of a novel tool for individual treatment trials in mucopolysaccharidosis.Journal of inherited metabolic disease · 2025Article
- A qualitative study on the facilitators and barriers to adopting the N-of-1 trial methodology as part of clinical practice: potential versus implementation challenges.International journal of qualitative studies on health and well-being · 2024Article
- The development of a set of key points to aid clinicians and researchers in designing and conducting n-of-1 trials.Trials · 2024Article
- A Series of Remote Melatonin Supplement Interventions for Poor Sleep: Protocol for a Feasibility Pilot Study for a Series of Personalized (N-of-1) Trials.JMIR research protocols · 2023Article
- Protocol of a feasibility study of a virtual personalized (N-of-1) trial for increasing low-intensity physical activity in older adults via habit formation.Contemporary clinical trials communications · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextWhen feasible, randomized, blinded single-patient (n-of-1) trials are uniquely capable of establishing the best treatment in an individual patient. Despite early enthusiasm, by the turn of the twenty-first century, few academic centers were conducting n-of-1 trials on a regular basis.
methodsThe authors reviewed the literature and conducted in-depth telephone interviews with leaders in the n-of-1 trial movement.
findingsN-of-1 trials can improve care by increasing therapeutic precision. However, they have not been widely adopted, in part because physicians do not sufficiently value the reduction in uncertainty they yield weighed against the inconvenience they impose. Limited evidence suggests that patients may be receptive to n-of-1 trials once they understand the benefits.
conclusionsN-of-1 trials offer a unique opportunity to individualize clinical care and enrich clinical research. While ongoing changes in drug discovery, manufacture, and marketing may ultimately spur pharmaceutical makers and health care payers to support n-of-1 trials, at present the most promising resuscitation strategy is stripping n-of-1 trials to their essentials and marketing them directly to patients. In order to optimize statistical inference from these trials, empirical Bayes methods can be used to combine individual patient data with aggregate data from comparable patients.
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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.