Hi there,
I am eager to hear from researchers or clinicians who have used n-of-1 studies for the above purposes. They seem to offer advantages over many other study designs, particularly for when there is little guidance or predictors of outcome on which therapeutic option to choose for a patient. They also seem rare, and most of the literature I've seen so far suggests that they have mostly been used for trying out different medicines.
I'm hoping to hear some encouraging stories of their use, but can see that there may be limitations with implementing them (due to costs / time etc.)
Depends what you want to do with the data. However, there are some great "how-to" texts that you might want to look at (e.g.):
Nikles J, Mitchell G, editors. The essential guide to N-of-1 trials in health. New York, NY, USA:: Springer, 2015.
Janosky JE, Leininger SL, Hoerger MP, Libkuman TM. Single-subject designs in biomedicine. Springer, 2009
There are others that go back further but check them out
Stephanie,
I came across this multiple single-subject design study when I was gathering info for a PhD class. I thought it was very well done with several outcome measures and 7 single-subject cases. I enjoy reading about single cases and find that the information shared by other clinicians is helpful to my own practice. However, I agree they are difficult to locate in the field of rehab.
Good luck
Fragala MA, O'neil ME, Russo KJ, Dumas HM. Impairment, disability, and satisfaction outcomes after lower-extremity botulinum toxin a injections for children with cerebral palsy. Pediatr Phys Ther. 2002;14(3):132-144. doi:10.1097/00001577-200214030-00003
N=1 studies may be useful for very preliminary investigations but are generally not sufficient to draw conclusions from.
There is too much possibility of regression to the mean, false attribution, and error of judgement/delusion.
An N=1 is not much different to an anecdote and the plural if anecdote is not proof.
I have never conducted an n-of-1 study. Tend to agree with the above posts that note the limitations of this type of study. You don't get a control sample for comparison with no intervention or a different treatment approach.
If presented as a case study, and n-of-1 study might be useful for alerting a reader to options for a therapeutic approach, and of course may stimulate ideas for higher sample size studies.
Thank you so much to Gerry Leisman , Jaap Swanenburg , Teresa Pierce , Christine Sutherland and Steven Jorgensen for sharing these resources and perspectives. It has helped me so much. Much appreciated!
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