Strengthening Rural Health With N-of-1 Trials and Single-Case Experimental Designs.

THE CHALLENGE: Rural and remote clinicians frequently make treatment decisions under conditions of uncertainty, exacerbated by limited access to specialist services, fewer locally available treatment options, and evidence that may not fully inform care for an individual patient.

THE OPPORTUNITY: N-of-1 trials and related single-case experimental designs (SCEDs) offer a structured method for generating individual-level evidence to support treatment decisions yet remain rarely used in routine clinical practice. Beyond informing care for individual patients, aggregated N-of-1 trials can also generate evidence that is directly relevant to rural populations and models of care.

IMPLICATIONS: This editorial outlines the potential of N-of-1 trials and SCEDs in rural and remote health and argues that increasing awareness, training, and practical support could enable their wider adoption.