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March 11, 2009

Using N-of-1 Trials in Evidence-Based Clinical Practice—Reply

JAMA. 2009;301(10):1022-1023. doi:10.1001/jama.2009.277

In Reply: Drs Tsapas and Matthews discuss the potential importance that individual patient trials or N-of-1 trials could play in the individualization of therapies and as a translational research tool. We agree that these are underused tools. In particular, they are best suited for the identification of the optimal management of the individual patient who has a stable condition and seeks symptom relief. To be suitable for an N-of-1 trial, the effect of the intervention should be short-lived. The usual efforts to reduce bias in randomized trials are important in the implementation of an N-of-1 trial, including blinding.1-3