Medicine is developing towards an era where treatments can be tailored to the individual.  This can be done by genetic testing to determine the likelihood that a treatment will work.  However, there is a simpler way - single patient or N-of-1 trials.

Single Patient trials (also called N-of-1 trials) are multiple-cycle, double blind, placebo-controlled crossover trials using standardised measures of effect. The randomisation order is independently generated for each patient. At the end of the trial the order is revealed, and the patient response is compared against the presence or absence of the test treatment.

N-of-1 trials are usually used for testing the effectiveness of medicines in individual patients.

The advantage of N-of-1 trials is that the individual patient and their clinician receive direct evidence about the effect of the treatment versus the comparator on their own symptoms, therefore treatment can be individually tailored.

It is also possible to combine the results of many N-of-1 trials to determine the effect of a therapy for a population, thus allowing rapid accumulation of strong evidence on treatment effects.

Our group have successfully completed over 600 of these trials in various areas eg palliative care and paediatric medicine. Our current work includes an international collaboration with researchers at the University of Alberta, in Canada.