Oura Ring Gen 4 sensor data, not clinical measurementsN=1 case study, not validated for clinical decisionsHEV diagnosed Mar 18; Day 109 post-ruxolitinibMore
Consumer wearable data can support exploratory review only. The HEV diagnosis, temporally confounded with treatment start, remains a material confounder.

Autonomic Recovery Trajectories

Module 1: Comparative Autonomic Analysis
P1 MEAN HRV
Alert
9.9ms
Below ESC threshold (15ms)
P1 SLEEP HR
Watch
83.9bpm
Elevated
P2 MEAN HRV
Info
50.9ms
Pop. percentile: 72%
P2 SLEEP HR
In range
62.1bpm
Normal range
P3 MEAN HRV
Info
26.7ms
Pop. percentile: 15%
P3 SLEEP HR
In range
57.2bpm
Normal range
TRAJECTORY
Improving
Improving
P1's 30-day HRV trend
RECENT WINDOW

Recent 30-Day Window vs Full History

HRV Full HRV 30d Low HR Full Low HR 30d Avg HR Full Avg HR 30d Full-Period Trend
P1 9.9 12.0 ▲ +21.5% 75.5 72.3 ▼ -4.2% 83.9 80.7 ▼ -3.9% IMPROVING (+0.58 ms/wk)
Regression: 6 → 14 ms over 95 days
P2 50.9 42.6 ▼ -16.3% 52.9 49.6 ▼ -6.1% 62.1 58.7 ▼ -5.5% DECLINING (-0.13 ms/wk)
Regression: 56 → 46 ms over 1869 days
P3 26.7 26.7 — +0.0% 52.3 52.3 — +0.0% 57.2 57.2 — +0.0% STABLE (-2.00 ms/wk)
Regression: 30 → 23 ms over 21 days
Decline Flags (recent 30d mean >10% below full-history mean):
⚠ P2 HRV: recent 30-day mean is 16.3% below full-history mean (50.9 → 42.6)

Full-period trend uses linear regression across each patient's entire data range. Declining = recent 30-day mean is more than 10% below full-history mean, indicating the full-history average overstates current health status.

HRV TRAJECTORY

Autonomic Recovery Trajectories

HR TRAJECTORY

Heart Rate Comparison

PCT BASELINE

Relative Recovery (% of Baseline)

HRV DISTRIBUTION

HRV Distribution Comparison

LONG TERM CONTEXT

Long-Term Context

AUTONOMIC COUPLING

Autonomic Coupling (HR vs HRV)

CLINICAL CONTEXT

Clinical Context

This report compares two fundamentally different clinical trajectories. Patient 1 is 2+ years post-allogeneic HSCT with chronic GVHD and severe autonomic dysfunction (HRV consistently below the ESC 15ms threshold). Patient 2 is ~15 months post-stroke (bilateral carotid/vertebral artery dissection) with mildly impaired but recovering autonomic function. Direct HRV magnitude comparison is less meaningful than trajectory shape and relative changes within each patient's own range.

Normalization approaches (z-score, percent-of-baseline) allow meaningful cross-patient comparison despite the 5x difference in absolute HRV values. All heart rate values are derived from sleep periods (not readiness scores). Oura readiness 'resting_heart_rate' is a 0-100 score and is never used as bpm.