Abstract
This chapter discusses issues and approaches related to systematic review and meta-analysis of N-of-1 trials. Some basic guidelines and methods are described in this chapter. Some important steps in a systematic review of these types of trials are discussed in detail. This is followed by a detailed description of meta-analytic methods, spanning both frequentist and Bayesian techniques. A previously undertaken meta-analysis of a comparison of treatments for fibromyalgia syndrome is discussed with some sample size considerations. This is further elaborated on through a discussion on the statistical power of studies through a comparison of treatments for chronic pain. The chapter concludes with some final thoughts about the aggregation of evidence from individual N-of-1 trials.
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References
Dallery J, Cassidy RN, Raiff BR (2013) Single-case experimental designs to evaluate novel technology-based health interventions. J Med Internet Res 15(2), e22
Dallery J, Raiff BR (2014) Optimizing behavioral health interventions with single-case designs: from development to dissemination. Transl Behav Med 4:290–303
Duan N, Kravitz RL, Schmid CH (2013) Single-patient (N-of-1) trials: a pragmatic clinical decision methodology for patient-centered comparative effectiveness research. J Clin Epidemiol 66:S21–S28
Gabler NB, Duan N, Vohra S, Kravitz RL (2011) N-of-1 trials in the medical literature: a systematic review. Med Care 49:761–768
Higgins J, Green SE (2008) Cochrane handbook for systematic reviews of interventions (eds) Wiley
Koricheva J, Gurevitch J, Mengersen K (eds) (2013) Hand-book of meta-analysis in ecology and evolution. Princeton University Press, Princeton
Kravitz RL, Duan N, The Decide Methods Centre N-of-1 Guidance Panel (Duan N, Eslick L, Gabler NB, Kaplan HC, Kravitz RL, Larson EB, Pace WD, Schmid CH, Sim I, Vohra S) (eds) (2014a) Design and implementation of N-of-1 trials: a user’s guide. Agency for Healthcare Research and Quality, Rockville
Kravitz R, Duan N, Vohra S, Li J (2014b) The DEcIDE methods centre N-of-1 guidance panel introduction to N-of-1 trial: indications and barriers. In: Kravitz R, Duan N, The Decide Methods Centre N-of-1 Guidance Panel (Duan N, Eslick L, Gabler NB, Kaplan HC, Kravitz RL, Larson EB, Pace WD, Schmid CH, Sim I, Vohra S) (eds) Design and imple-mentation of N-of-1 trials: a user’s guide. Agency for Healthcare Re-search and Quality, Rockville
Lillie EO, Patay B, Diamant J, Isseli B, Topol EJ, Schoril NJ (2011) The N-of-1 clinical trial: the ultimate strategy for individualizing medicine? Pers Med 8(2):161–173
Schmid C, Duan N (2014) The DEcIDE methods centre N-of-1 guidance panel statistical design and analytic consideration for N-of-1 trials. In: Kravitz RL, Duan N, Eslick L, Gabler NB, Kaplan HC, Kravitz RL, Larson EB, Pace WD, Schmid CH, Sim I, Vohra S (eds) Design and implementation of N-of-1 trials: a user’s guide. Agency for Healthcare Research and Quality, Rockville
Senior HE, Mitchell GK, Nikles J, Carmont SA, Schluter PJ, Currow DC, Vora R, Yelland MJ, Agar M, Good PD, Hardy JR (2013) Using aggregated single patient (N-of-1) trials to determine the effectiveness of psychostimulants to reduce fatigue in advanced cancer patients: a rationale and protocol. BMC Palliat Care 12:17
Yelland MJ, Poulos CJ, Pillans PI, Bashford GM, Nikles CJ, Sturtevant JM, Vine N, Del Mar CB, Schluter PJ, Tan M, Chan J, Mackenzie F, Brown R (2009) N-of-1 randomized trials to assess the efficacy of gabapentin for chronic neuropathic pain. Pain Med 10:754–761
Zucker DR, Schmid CH, Mcintosh MW, D’agostino RB, Selker HP, Lau J (1997) Combining single patient (N-of-1) trials to estimate population treatment effects and to evaluate individual patient responses to treatment. J Clin Epidemiol 50:401–410
Zucker DR, Ruthazer R, Schmid CH, Feuer JM, Fischer PA, Kieval RI, Mogavero N, Rapoport RJ, Selker HP, Stotsky SA, Winston E, Goldenberg DL (2006) Lessons learned combining N-of-1 trials to assess fibromyalgia therapies. J Rheumatol 33:2069–2077
Zucker DR, Ruthazer R, Schmid CH (2010) Individual (N-of-1) trials can be combined to give population comparative treatment effect estimates: methodologic considerations. J Clin Epidemiol 63:1312–1323
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Mengersen, K., McGree, J.M., Schmid, C.H. (2015). Systematic Review and Meta-analysis Using N-of-1 Trials. In: Nikles, J., Mitchell, G. (eds) The Essential Guide to N-of-1 Trials in Health. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7200-6_16
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DOI: https://doi.org/10.1007/978-94-017-7200-6_16
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