In this single patient experiment, an 11-year-old patient with Crohn’s disease (and her parents) teamed up with Shehzad Saeed, MD of Cincinnati Children’s Hospital Medical Center* to test whether a change in probiotic therapy would improve the patient’s stool urgency (sudden, irresistible need to have a bowel movement).

The hypothesis was that probiotics were reducing the patient’s urgent need to use the bathroom. To learn more, Dr. Saeed and the patient used the Personalized Learning System (PLS) – a web-based platform that enabled them to co-design the experiment, collect data in a variety of ways (SMS messaging, email, web-survey, and/or biosensors like the Fitbit), and review the data together to look for associations between symptoms and probiotic therapy.

Over the course of three months, the patient was on and off different probiotics. During that time, the data show a gradual improvement in urgency and PROMIS Fatigue scores, neither of which seem to be related to the use of probiotics.

After three months of monitoring, the patient’s disease exacerbated, with diarrhea and increased urgency. While urgency and PROMIS fatigue scores both increased, it again seemed to be unrelated to the use of probiotics.


Because of this PLS experiment, the patient and Dr. Saeed determined that probiotics were not having a positive or negative effect on urgency and fatigue. While, the results of this experiment may be inconclusive, it was still important and valuable. Working closely together during this experiment, the relationship between patient/family and providers was strengthened and enhanced. Real-time tracking of symptoms gave greater insight into the patient’s individual experience, and allowed improved confidence for both patient and providers’ ability to gauge the association between cause and effect of a specific intervention. And in the future, they may continue to use PLS to track real-time symptoms, assess responses to interventions, and capture day-to-day symptoms to look for patterns that may predict a flare of disease activity, so it can be prevented.

For more information on the PLS and patient experiments, read the HBR Blog Network post here.


* Dr. Saeed has moved to Dayton Children’s Hospital (also a participating ImproveCareNow center)

Editor's Note: This article was reviewed and approved in January 2018. 

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