Reporting quality of N-of-1 trials published between 1985 and 2013: a systematic review

• Published in: Journal of clinical epidemiology Vol. 76; pp. 57 - 64
• Main Authors: Li, Jiang, Gao, Wei, Punja, Salima, Ma, Bin, Vohra, Sunita, Duan, Naihua, Gabler, Nicole, Yang, Kehu, Kravitz, Richard L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2016; Elsevier Limited
• Subjects: Biomedical Research - standards; Biomedical Research - trends; Chronic Disease; Clinical Trials as Topic - standards; Confidence intervals; CONSORT guidelines; Data Accuracy; Epidemiology; Forecasting; Funding; Guidelines as Topic; Humans; Impact factors; Institutional repositories; Internal Medicine; Intervention; Pharmacology; Publishing - standards; Publishing - trends; Quality; Reporting quality; Research Design - standards; Research Design - trends; Research Report - standards; Research Report - trends; Researchers; Single-patient (N-of-1) trials; Studies; Terminology as Topic; Therapy Comparative Effectiveness Research; Australia; North America; ANE, Europe; CONSORT guidelines; Therapy Comparative Effectiveness Research; Reporting quality; Single-patient (N-of-1) trials; Chronic Disease
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2015.11.016

To evaluate the quality of reporting of single-patient (N-of-1) trials published in the medical literature based on the CONSORT Extension for N-of-1 Trials (CENT) statement and to examine factors that influence reporting quality in these trials. Through a search of 10 electronic databases, we identified N-of-1 trials in clinical medicine published between January 1, 1985, and December 31, 2013. Two reviewers screened articles for eligibility and independently extracted data. Quality assessment was performed using the CENT statement. Discrepancies were resolved by consensus. We identified 112 eligible N-of-1 trials published in 87 journals and involving a total of 2,278 patients. Overall, kappa agreement between the two evaluators for compliance with CENT criteria was 0.80 (95% confidence interval: 0.79, 0.82). Trials assessed pharmacology and therapeutics (87%), behavior (11%), or diagnosis (2%). Although 87% of articles described the trial design (including the planned number of subjects and length of treatment period), the median percentage of specific CENT elements reported in the Methods was 41% (range, 16–87%), and the median percentage in the Results was 38% (range, 32–93%). First authors were predominantly from North America (46%), Europe (29%), and Australia (17%). Quality of reporting was higher in articles published in journals with relatively high-impact factors (P = 0.004). The quality of reporting of published N-of-1 trials is variable and in need of improvement. Because the CENT guidelines were not published until near the end of the period of this review, these results represent a baseline from which improvement may be expected in the future.