Cargando…

An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial

The call for personalized medicine highlights the need for personalized (N-of-1) trials to find what treatment works best for individual patients. Conventional (between-subject) randomized controlled trials (RCT) yield effects for the ‘average patient,’ but a personalized trial administers all treat...

Descripción completa

Detalles Bibliográficos
Autor principal: Chandereng, Thevaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121210/
https://www.ncbi.nlm.nih.gov/pubmed/37091071
http://dx.doi.org/10.1162/99608f92.6c21dab7
_version_ 1785029333000126464
author Chandereng, Thevaa
author_facet Chandereng, Thevaa
author_sort Chandereng, Thevaa
collection PubMed
description The call for personalized medicine highlights the need for personalized (N-of-1) trials to find what treatment works best for individual patients. Conventional (between-subject) randomized controlled trials (RCT) yield effects for the ‘average patient,’ but a personalized trial administers all treatments within-subject, so benefits or harms to the individual patient can be identified. The design and analysis of personalized trials involve different strategies from the conventional RCT. These include how to adjust for any carryover effects from one intervention to another, how to handle missing data, and how to provide patients with insight into their data. In addition, a comprehensible report about trial results should be created for each patient and their clinician to facilitate their decision-making. This article describes strategies to address these design and analytic issues, and introduces an R shiny app to facilitate their solution, to explain the use of each of the design and statistical strategies. To illustrate, we also provide a concrete example of a personalized trial series designed to increase activity (i.e., walking steps) in patients with chronic lower back pain (CLBP).
format Online
Article
Text
id pubmed-10121210
institution National Center for Biotechnology Information
language English
publishDate 2022
record_format MEDLINE/PubMed
spelling pubmed-101212102023-04-21 An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial Chandereng, Thevaa Harv Data Sci Rev Article The call for personalized medicine highlights the need for personalized (N-of-1) trials to find what treatment works best for individual patients. Conventional (between-subject) randomized controlled trials (RCT) yield effects for the ‘average patient,’ but a personalized trial administers all treatments within-subject, so benefits or harms to the individual patient can be identified. The design and analysis of personalized trials involve different strategies from the conventional RCT. These include how to adjust for any carryover effects from one intervention to another, how to handle missing data, and how to provide patients with insight into their data. In addition, a comprehensible report about trial results should be created for each patient and their clinician to facilitate their decision-making. This article describes strategies to address these design and analytic issues, and introduces an R shiny app to facilitate their solution, to explain the use of each of the design and statistical strategies. To illustrate, we also provide a concrete example of a personalized trial series designed to increase activity (i.e., walking steps) in patients with chronic lower back pain (CLBP). 2022 2022-09-08 /pmc/articles/PMC10121210/ /pubmed/37091071 http://dx.doi.org/10.1162/99608f92.6c21dab7 Text en https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution (CC BY 4.0) International license, except where otherwise indicated with respect to particular material included in the article.
spellingShingle Article
Chandereng, Thevaa
An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title_full An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title_fullStr An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title_full_unstemmed An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title_short An R Shiny App for a Chronic Lower Back Pain Study, Personalized N-of-1 Trial
title_sort r shiny app for a chronic lower back pain study, personalized n-of-1 trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121210/
https://www.ncbi.nlm.nih.gov/pubmed/37091071
http://dx.doi.org/10.1162/99608f92.6c21dab7
work_keys_str_mv AT chanderengthevaa anrshinyappforachroniclowerbackpainstudypersonalizednof1trial
AT chanderengthevaa rshinyappforachroniclowerbackpainstudypersonalizednof1trial