N of 1 Trials, Self Tracking and Personal Experiments
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A talk given by Paul Abramson MD on 8/25/12 at the Medicine of Cycling Conference at the Olympic Training Center, Colorado Springs. Discusses N of 1 experimental design, the Quantified Self movement, and a paradigm for implementing self tracking and the Quant Coach in medical care in order to empower patients.
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N of 1 Trials, Self Tracking and Personal Experiments
- 1. N OF 1 TRIALS Self Tracking and Personal Experiments Paul Abramson MD My Doctor Medical Group - San Francisco @paulabramsonmd Saturday, August 25, 12
- 2. DISCLOSURES no conflicts of interest to disclose Saturday, August 25, 12
- 3. THE QUANTIFIED SELF self-tracking geeks unite Saturday, August 25, 12
- 4. QS CONFERENCE #3 Stanford University, September 2012 Saturday, August 25, 12
- 5. QUANTIFIED MANIA self-tracking goes mainstream Saturday, August 25, 12
- 6. Saturday, August 25, 12
- 7. WHY SELF TRACK? Saturday, August 25, 12
- 8. DO YOU HAVE A PROBLEM? that’s hard to solve Saturday, August 25, 12
- 9. OR A QUESTION? that matters to you Saturday, August 25, 12
- 10. OR A DESIRED CHANGE? how can I improve my sleep? Saturday, August 25, 12
- 11. FEEDBACK gathering data can facilitate insight and change Saturday, August 25, 12
- 12. RANDOMIZED TRIAL large numbers are better Saturday, August 25, 12
- 13. N OF 1 TRIAL just you Saturday, August 25, 12
- 14. N OF 1 TRIALS an opportunity to tailor treatment to the individual Saturday, August 25, 12
- 15. STUDY OF N OF 1 TRIALS • 70 trials begun, 57 finished • 50 trials resulted in definitive answer • 39% of trials with enough data resulted in a change in plan Arch Int Med 1990- PMID 2297206 Saturday, August 25, 12
- 16. QUININE AND LEG CRAMPS • 13 primary care patients already on quinine for leg cramps •2 week washout • Three 4-week treatment blocks: quinine vs. placebo • Outcome measures: • patient diaries of cramp occurance, duration, severity • capsule counts Br J Gen Pract 2005- • blood quinine levels PMID 15808032 Saturday, August 25, 12
- 17. QUININE AND LEG CRAMPS • 10 patients completed the trial •3 patients showed significant benefit of quinine (p < 0.05) •6 showed non-significant benefit • One showed no benefit Saturday, August 25, 12
- 18. N OF 1 TRIAL DESIGN Saturday, August 25, 12
- 19. PASSIVE SENSORS biometric - environmental Saturday, August 25, 12
- 20. ZEPHYR BIOHARNESS Saturday, August 25, 12
- 21. quantified-mind.com mymee.com ACTIVE TRACKING APPS mindfulness required Saturday, August 25, 12
- 22. OTHER DATA SOURCES calendar - e-mail - GPS data - government agencies - etc. Saturday, August 25, 12
- 23. VISUALIZATION TOOLS bodytrack - fluxtream Saturday, August 25, 12
- 24. VISUALIZATION TOOLS Saturday, August 25, 12
- 25. VISUALIZATION TOOLS Saturday, August 25, 12
- 26. DEFINE THE PROBLEM specific - simple Saturday, August 25, 12
- 27. DESIGN THE EXPERIMENT achievable - time-limited Saturday, August 25, 12
- 28. IMPLEMENTATION pick tools - assemble team Saturday, August 25, 12
- 29. FEEDBACK AND ADJUSTMENT data - process - story - coaching Saturday, August 25, 12
- 30. END THE EXPERIMENT assess the results - tell the story Saturday, August 25, 12
- 31. Quant Coach Doctor Team Coach Self Tracker Other Practitioners Saturday, August 25, 12
- 32. WHERE TO LEARN MORE •quantifiedself.com •quantdoctor.com •bodytrack.org •quantified-mind.com •mainstream media Saturday, August 25, 12
- 33. CONTACT INFO: PAUL ABRAMSON MD mydoctorsf.com @paulabramsonmd office@mydoctorsf.com 415-963-4431 Saturday, August 25, 12