Single-subject designs as a tool for evidence-based clinical practice: Are they unrecognised and undervalued?

Neuropsychol Rehabil. 2009 Dec;19(6):904-27. doi: 10.1080/09602010903040691. Epub 2009 Jul 28.


One could be forgiven for thinking that the only road to evidence-based clinical practice is the application of results from randomised controlled trials (or systematic reviews of such). By contrast, single-subject designs in the context of evidence-based clinical practice are believed by many to be strange bedfellows. In this paper, we argue that single-subject designs play an important role in evidence-based clinical practice. We survey the contents of Neuropsychological Rehabilitation in relation to single-subject designs and tackle the main criticisms that have been levelled against them. We offer practical guidance for rating the methodological quality of single-subject designs and applying statistical techniques to measure treatment efficacy. These guides are equally applicable to research studies and everyday clinical practice with individual patients.

MeSH terms

  • Brain Diseases / rehabilitation*
  • Brain Injuries / rehabilitation
  • Evidence-Based Medicine / methods*
  • Humans
  • Rehabilitation / methods
  • Research Design*