Inter-rater reliability was excellent, for pairs of both experienced and trained novice raters. Psychometric evaluation indicated that the RoBiNT Scale showed evidence of construct (discriminative) validity. Three changes resulted in a radically revised instrument, now entitled the Risk of Bias in N-of-1 Trials (RoBiNT) Scale: (i) item content was revised and increased to 15 items, (ii) two subscales were developed for internal validity (IV 7 items) and external validity and interpretation (EVI 8 items), and (iii) the scoring system was changed from a 2-point to 3-point scale to accommodate currently accepted standards. We report on a major revision of our method quality instrument, the Single-Case Experimental Design Scale. Consequently, the availability of tools to critically appraise single-case reports is of great importance.
Recent literature suggests a revival of interest in single-case methodology (e.g., the randomised n-of-1 trial is now considered Level 1 evidence for treatment decision purposes by the Oxford Centre for Evidence-Based Medicine).
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