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Activity Number: 65
Type: Topic Contributed
Date/Time: Sunday, August 3, 2014 : 4:00 PM to 5:50 PM
Sponsor: Health Policy Statistics Section
Abstract #312749 View Presentation
Title: N-of-1 Trial as a Clinical Decision Tool: An mHealth Application
Author(s): Naihua Duan*+ and Christopher Schmid
Companies: Columbia University and Brown University
Keywords: Clinical decision ; Comparative effectiveness ; mHealth ; N-of-1 trial ; Patient-centered ; Single-patient trial
Abstract:

The N-of-1 trial is a promising tool to enhance clinical decision-making and patient outcomes. These trials are single-patient multiple-crossover studies for determining the comparative effectiveness of two or more treatments within each individual patient. Patient and clinician select treatments and outcomes of interest to them, carry out the trial, and then make a treatment decision together based on results of the trial. To test the effectiveness of the N-of-1 trial as a patient-centered clinical decision tool, we are carrying out a study comparing health outcomes at 6 months after baseline between patients randomized to the N-of-1 trial vs. patients randomized to standard care. The N-of-1 trial is implemented using an mHealth mobile application that provides each patient with medication schedule, data entry and clinician communication capabilities. The results of each trial are presented graphically to inform treatment decision, based on automated Bayesian analyses of treatment effects, including point estimates, credible intervals and posterior probabilities of treatment benefit in clinically significant and non-significant regions.


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