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April 20, 1994

Randomized Clinical Trials in Single Patients

Author Affiliations

University of Tennessee Memphis

JAMA. 1994;271(15):1159. doi:10.1001/jama.1994.03510390029017

To the Editor.  —Single patient trials (SPTs) as described by Dr Larson and colleagues1 are an important approach to resolving some of the therapeutic questions faced in practice. I would like the authors to clarify the issue of costs.Currently, licensed residents in the Memphis, Tenn, area can moonlight for a starting wage of $50 per hour. Using the data provided by Larson et al (16.75 staff hours with estimated direct costs of $450 to $500 per trial), the cost is approximately $30 per hour.If staff time is to be calculated using physicians, shouldn't these figures be adjusted upward? Single patient trials are important tools for professional development, not only among full-time faculty, but particularly among clinical faculty. In this academic department of family medicine, academic faculty "cost" more than $60 per hour in salary and benefits. Even with these upward adjustments, participation in an SPT service should

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