N-of-1 Studies to Improve Symptoms and Individualize Treatment Efficacy in Pediatric Inflammatory Bowel Disease

Faculty Contact: Jeremy Adler, MD, MSc

Despite remarkable advances in treatments for inflammatory bowel disease (IBD), 40% of patients continue to have symptoms that are not relieved and have persistent fatigue and poor quality of life. To improve quality of life, individualized approaches to address symptoms troubling to individual patients are needed.


  1. To use mobile technology to monitor individualized patient symptoms with daily two-way text messages and conduct single-subject (N-of-1) treatment trials.
  2. To correlate daily collected symptom data with objective assessments of disease activity
  3. To utilize individual patient-level symptom data reports to guide therapy for IBD and determine if this strategy improves quality of life.

This project involves a collaboration through the ImproveCareNow (ICN) Network between the University of Michigan and Cincinnati Children's Hospital Medical Center.

  1. The research team will recruit patients and physicians from collaborating sites within the ICN Network to conduct N-of-1 trials.
  2. Patients will identify symptoms concerning to them which they will track on a daily basis with text messages.
  3. The patient and physician will jointly decide on treatments to be trialed. These may include medication trials, dietary changes, or lifestyle modifications.
  4. Graphical displays of patient symptom data will be reviewed by the patient and physician together to determine the optimal treatment to improve symptoms and quality of life.

For more information, please contact:
Jeremy Adler, MD, MSc
Child Health Evaluation and Research (CHEAR) Unit
University of Michigan Division of General Pediatrics
300 North Ingalls, Ann Arbor, Michigan 48109-5456