The use of an N-of-1 randomised clinical trial in resolving therapeutic doubt. The case of a patient with an 'attention disorder'.

OBJECTIVE: To describe the use of an N-of-1 randomised clinical trial (N-of-1 RCT) in general practice as illustrated by the case of a 16 year old boy with a learning and attention problem whose parents were convinced that amphetamines were necessary.
DESIGN: The N-of-1 RCT with a double blind technique was used in which a single patient served as his own control in testing whether amphetamine had any advantage over placebo.
RESULTS: No difference was noted in the boy's teachers' behavioural assessment scores nor in his own self reported ability to concentrate when taking either amphetamine or placebo.
CONCLUSION: This study showed that this patient obtained no objective improvement from amphetamine and the result was well accepted by his parents. N-of-1 RCTs are a relatively easy technique for tackling any area of therapeutic doubt. They can help the thoughtful GP to feel 'more like a scientist and less like a quack'.

RCT Entities:   Population Interventions Outcomes