Friday, November 30, 2012

The one about the ship-wrecked epidemiologists



Just what the world needs.... another inadequately discoverable journal! The number of medical journals is doubling every 20 years - and trials are scattered across so many, that it is becoming ever harder to track them down. Just how many journals do you need to read?, blogs Paul Glasziou.  Richard Smith and Ian Roberts argue that trials shouldn't even be published in journals any more.

And in case you were wondering what an n-of-1 trial is: it's a trial with one person in it (number = 1). It means the patient is their own control in a structured experiment. For example, an "n of 1 trial" of a particular drug would mean taking it for a pre-specified time, stopping for a pre-specified time, and so on. You can read more about this kind of trial here. (Or you could ponder how a trial on "n of 1"s had to be terminated because of lack of enrollment - and I thought I had a tough week!)

[Update 12 April 2016] Salima Punja studied meta-analysis of n-of-1 trials for her doctoral dissertation (here). Together with colleagues, she's incorporated n-of-1 trials with RCTs in a meta-analysis and concludes it improved the result. That study is here.

[Update 19 August 2016] Are n-of-1 trials going to boom in the age of "personalized medicine"? These authors address whether they are research that need ethics approval. Leaning towards yes, they're research but no, they don't need to go to ethics committee.