Tervo Raymond C, Estrem Theresa L, Bryson-Brockmann William, Symons Frank J
Department of Pediatrics, University of Minnesota, Minneapolis, USA.
J Dev Behav Pediatr. 2003 Dec;24(6):438-48. doi: 10.1097/00004703-200312000-00007.
This article discusses single-case experimental designs (SCEDs) and their relevance to developmental-behavioral pediatrics. Information concerning SCEDs have not been described in the Journal of Developmental and Behavioral Pediatrics, despite its relevance to the field. General issues related to the underlying logic and applications of SCEDs are reviewed with examples selected from the literature to illustrate the strengths and weaknesses of different design strategies. It is suggested that SCEDs can be a useful alternative to traditional between-group designs for clinical and evaluation research because the unit of the analysis is the individual; therefore the feedback to clinicians and families is direct about the effectiveness of a behavioral intervention or medication for that individual. In the field of developmental-behavioral pediatrics, SCEDs can be especially useful in the management of vague symptoms or poorly defined diseases to improve the confidence in a treatment decision for an individual patient. This report is intended to facilitate the understanding and use of single-case methodology so that clinicians are aware that flexible, true experiential designs exist to fill the gap in knowledge and also "do the best for my patient."
本文讨论了单病例实验设计(SCEDs)及其与发育行为儿科学的相关性。尽管单病例实验设计与该领域相关,但《发育与行为儿科学杂志》尚未对其进行描述。本文回顾了与单病例实验设计的基本逻辑和应用相关的一般问题,并从文献中选取实例来说明不同设计策略的优缺点。有人认为,对于临床和评估研究而言,单病例实验设计可以作为传统组间设计的一种有用替代方法,因为分析单位是个体;因此,关于行为干预或药物对该个体有效性的反馈可以直接提供给临床医生和家庭。在发育行为儿科学领域,单病例实验设计在处理模糊症状或定义不明确的疾病时可能特别有用,从而提高对个体患者治疗决策的信心。本报告旨在促进对单病例方法的理解和应用,使临床医生意识到存在灵活、真实的实验设计来填补知识空白,并“为我的患者做到最好”。