Love this @Kaveh and one KEY reason of MANY you find me here in this beautiful tree house.
Many of us don’t realize that most patients don’t benefit from many of the routine medications I prescribe as a physician. There’s a fancy term for this: numbers needed to treat (NNT). In the common tongue, for medications, this refers to the total numebr of patients I need to treat with a specific medication for ONE to repond in the way we hoped. A concrete example - I need to prescribe 104 patients without known heart diease (their cholesterol is elevated) a statin medication for 5 years for one of the to prevent a heart attack - Statins for Heart Disease Prevention (Without Prior Heart Disease) – TheNNTTheNNT. the NNT is a great website that looks closely at these numbers.
You can imagine that this can be frustrating for a physician. That’s a LOT of people taking a medication and risking potential harms (NNH or numbers needed to harm is another fascinating data point). How do you identify that one patient and save the other 103 the potential side effects of the medication??
The answer to this is : 1.) start with interventions that have lowest potential for side effects (highest NNH) 2.) personalize the therapy to the individual patient. Enter the idea of N-of-1 trials. Common sense for most of us - especially in more subjective/individualized issues like sleep - let each person decide what is best for them! Personalized medicine: Time for one-person trials | Nature.
VERY excited for each of the 300 pioneers to NOT to have their therapy unfallingly dictated by a study that may not pertain to them, NOR be directed by a therapy ONLY becuase it passed the necessary hurdles to be an approved pharmaceutical, but rather DECIDE themsleves if the therapy is helpful and/or contributes to their overall health.
Go Pioneers!