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<a href="http://doi.org/10.1016/s0895-4356(96)00429-5" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0895-4356(96)00429-5</a>
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Title
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Combining single patient (N-of-1) trials to estimate population treatment effects and to evaluate individual patient responses to treatment
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Journal Of Clinical Epidemiology
Date
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1997
Subject
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Humans; Outcome Assessment (Health Care); Research Design; Antidepressive Agents; Cross-Over Studies; Models; Statistical; Chronic disease; Amitriptyline/therapeutic use; Bayes Theorem; Fibromyalgia/drug therapy; Randomized Controlled Trials as Topic/statistics & numerical data; Tricyclic
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Zucker DR; Schmid CH; McIntosh MW; D'Agostino RB; Selker HP; Lau J
Description
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When treating individual patients, physicians may face difficulties using the evidence from center-based randomized control trials (RCTs) due to limitations in these studies generalizability. Therefore, they often perform their own "informal" tests of treatment effectiveness. Single patient ("N-of-1") trials provide a structured design for more rigorous assessment of medical treatments of chronic diseases, but are applied only to the index patient. We present a hierarchical Bayesian random effects model to combine N-of-1 studies to obtain an estimate of treatment effectiveness for the population and to use this population information to aid in the evaluation of an individual patient's trial results. The model's treatment effect estimates are adjustments between the population estimate and the individual's observed results. This adjustment is based upon the within-patient and between-patient heterogeneity. We demonstrate this patient-focused method using published data from 23 N-of-1 trial results comparing amitriptyline and placebo for the treatment of fibromyalgia.
1997
Identifier
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<a href="http://doi.org/10.1016/s0895-4356(96)00429-5" target="_blank" rel="noreferrer">10.1016/s0895-4356(96)00429-5</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
1997
Amitriptyline/therapeutic use
Antidepressive Agents
Backlog
Bayes Theorem
Chronic Disease
Cross-Over Studies
D'Agostino RB
Fibromyalgia/drug therapy
Humans
Journal Article
Journal Of Clinical Epidemiology
Lau J
McIntosh MW
Models
Outcome Assessment (health Care)
Randomized Controlled Trials as Topic/statistics & numerical data
Research Design
Schmid CH
Selker HP
statistical
Tricyclic
Zucker DR