Project 1: The International Collaborative Network

Field: Data analytics

Location: UQ Centre for Clinical Research (Herston)

Type of student: Both types will be considered (i.e. you are flexible with your project/s)

Type of work: Clinical work 

Brief synopsis:

We need a keen student to assist with research projects and administration of the ICN.
Vision: A world where individualised health research (for both single and groups of individuals) is an integral part of clinical practice and health research.

Mission: To develop a global partnership to promote, support, strengthen and evaluate the impact of individualised health research, and to share knowledge, experience, expertise, resources and data.
 

Website:  https://nof1andsced.wixsite.com/home/blog-paper

 

Project 2:  International Collaborative Network for N-of-1 Clinical Trials and Single-Case Experimental Design

Field: Health Services

Location: UQ Centre for Clinical Research (Herston)

Type of student: Both types will be considered (i.e. you are flexible with your project/s)

Type of work: This project will involve helping with the key activities of the ICN including the management and growth of membership, website and communications, social media, committee arrangements and other strategic tasks. 

Brief synopsis

The International Collaborative Network for N-of-1 Clinical Trials and Single-Case Experimental Designs aims to advance the science of individualised research. The ICN has 150 members from all over the world who are using n-of-1 trials and single-case experimental designs. For more information about the ICN please click here.

Prerequisite skills: N/A

Time frame: N/A

WebsiteN/A

 

Project 3: Exploring Patient and Clinician Perspectives about using N-of-1 trials in Clinical Practice

Field: Health services

Location: UQ Centre for Clinical Research (Herston)

Type of student: Both types will be considered (i.e. you are flexible with your project/s)

Type of work:

  • Literature review 
  • Qualitative methods 

Brief synopsis:

Background: N‐of‐1 trials are randomised controlled trials of treatment versus a placebo (or another treatment) within an individual patient to determine individual response to treatment (please click here for futher information and examples). N-of-1 trials provide the highest level of evidence for making treatment decisions for individual patients. Despite this, previous research has identified potential barriers to the uptake of n-of-1 trials in clinical practice. This study aims to explore clinician and patient perspectives about the use of n-of-1 trials in clinical practice.

Methods: Two* online, theory-based surveys will be developed to explore (1) clinicians' views in relation to conducting n-of-1 trials in clinical practice and (2) patients' views in relation to participating in n-of-1 trials in clinical practice. The questionnaire items in both online surveys will be based on the Theoretical Domains Framework (TDF; Michie et al., 2005). The TDF provides a broad and inclusive approach to understanding theory-based predictors of clinical and health-related behaviour. The TDF was developed by an expert consensus group, which reviewed 33 behavioural theories and their associated 128 theoretical constructs, identifying 12 theoretical domains based on commonalities between constructs. The TDF broadly covers all scientific explanations of behaviour based on current theorising and has been used widely to understand the perceptions and behaviours of clinicians and patients. Data from the project will be analysed quantitatively. The survey results will provide important insights about potential barriers and facilitators in relation to the uptake of n-of-1 trials in clinical practice.

Learning objectives: The students will learn about a novel research method; N-of-1 methods play a key role in the movement towards personalised medicine, shared-decision-making and patient-centred healthcare. Students will gain experience in developing and analysing survey research. *One student will work on the clinician survey and one student will work on the patient survey.

Prerequisite skills: N/A

Time frame:N/A

WebsiteN/A

Project 4: Exploring fluctuations in fatigue symptoms in Multiple Sclerosis using N-of-1 methods

Field: Neuroscience

Location:

UQ Centre for Clinical Research (Herston) 

Type of student: Both types will be considered (i.e. you are flexible with your project/s)

Type of work:

Clinical work 
Literature review 

Brief synopsis:

Background: Fatigue is one of the most commonly reported, most disabling but least understood symptom experienced by patients with Multiple Sclerosis (MS). Patterns and predictors of fatigue may differ considerably from one individual to another but these differences are concealed in research using group-based designs (e.g. randomised controlled trials) that focus on average results for the group studied. Tools for assessing fatigue symptoms typically involve self-reported retrospective recall which can be subject to a number of memory biases. Furthermore, fatigue assessment is typically conducted on only one occasion, which results in a limited understanding about how fatigue fluctuates over time. N-of-1 methods involve the repeated, quantitative and prospective measurement of a health-related outcome in an individual over time. N-of-1 methods can be used to identify patterns and predictors of fatigue over time that are unique to the individual. Methods: This project will involve a series of n-of-1 observational studies to explore fluctuations in fatigue and potential predictors (activity, sleep, stress, mood etc.) over time in MS. Daily data about fatigue and potential predictors will be collected from participants three times per day for a period of 6 weeks using an electronic diary with integrated physical activity monitor. Data will be analysed using time series analysis. Participants will receive detailed feedback about the patterns and predictors of their fatigue at the end of the study, which may lead to better self-management of fatigue symptoms.

Learning objectives: The student(s) will learn about a novel research method; N-of-1 methods play a key role in the movement towards personalised medicine, patient-centred health care and shared decision-making. The student(s) will gain experience and skills in relation to conducting an n-of-1 study with a clinical population.

Prerequisite skills: N/A

Time frame: N/A

Website: N/A

 

Project 5: Melatonin for insomnia in Parkinsons disease

 

Field: Mental health and Neuroscience

Location: UQ Centre for Clinical Research (Herston)

Type of student: Both PhD/MPhil and Volunteer

Objectives:

The primary aim of this study is to use n-of-1 trials to improve the precision of clinical decision making in prescribing melatonin for individual adults with Parkinson’s Disease (PD) and insomnia, by identifying individual responders and non-responders to melatonin.

Secondary aims are to: 

1. To aggregate group data from a series of n-of-1 trials to arrive at group estimates of the effectiveness (measured by improvements in Parkinson’s Disease Sleep Scale-2) and safety (measured by adverse events) of melatonin in improving sleep quality in Parkinson’s Disease.

2. To assess feasibility of offering IMET trials for the use of melatonin for insomnia in all suitable people with Parkinson’s Disease.

Methodology:

Each participant will undergo 3 pairs of treatment/placebo. Participants will receive either immediate release melatonin or placebo 30 mins before bedtime. Immediate release melatonin will be sourced from overseas. Two doses will be available (3 mg or 6 mg) in personalised n-of-1 tests. Subjects will undergo a run-in period starting on 3 mg. If this appears effective, they will do the trial on that dose; if not, they will trial 6 mg. For both doses, the comparator will be placebo. 

Using manufacture of matched placebo, the melatonin and placebo will be identical in every way. Patients will keep daily sleep diaries and will wear an actigraph throughout the trial period. After the trial, patients will be unblinded during the process of discussing their results with their doctor based on an individual report provided by trial staff.  Thus the trial will provide direct and immediate feedback to patients about the effectiveness and safety of melatonin for them.

 

Supervisor

Dr Jane Nikles

Dr Jane Nikles

Senior Research Fellow
UQ Centre for Clinical Research