Application of heart rate variability during blood pressure measurement in patients with somatic symptom disorder, 2020, Huang et al

Andy

Retired committee member
Objective
This study wants to test whether the heart rate variability (HRV) analysis using sphygmomanometers can effectively reflect the physical and emotional distress of somatic symptom disorder (SSD) cases and assist in further health management.

Methods
This study includes 66 female SSD cases and 32 male SSD cases. All cases received a 200-second blood pressure (BP) measurement, after which the numerical figure for the heart rate was obtained from the BP signal for HRV analysis. All cases also filled out Patient Health Questionnaire-15 (PHQ-15), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI) to understand the extent of their somatic distress, depression, and anxiety. The relationship between psychological conditions and HRV indicators are examined statistically. Receiver operating characteristic (ROC) curve analysis was used to understand whether HRV indicators can assist in the determination of psychosomatic problems.

Results
Considering all and female SSD cases, low-frequency power (LF) and PHQ-15 in the HRV index have the most significant correlations. In male SSD cases, root mean square of successive NN interval differences (RMSSD) and BDI-II have the highest correlations. The results of ROC curve analysis indicate that LF is useful to judge the severity of female SSD cases, while RMSSD has reference value in determining whether male patients of SSD cases have depression or not. In addition, physical stress index (PSI) can also help determine the degree of depression in male SSD cases.

Conclusion
The use of BP in HRV analysis can help in the monitoring of somatic distress and depression issues in SSD cases. LF, RMSSD, PSI are potential physiological indicators.
Paywall, https://www.jocn-journal.com/article/S0967-5868(19)32145-9/fulltext
Not available via Sci hub at time of posting.
 
Just from the abstract.
Somatic symptom disorder - so a group of people with heterogeneous somatic symptoms.
No healthy controls; no controls with a chronic non-MUS disease.

Looks like the researchers made multiple comparisons and only found a few probably random things correlated. (No indication of the strength of those correlations.)

And they assumed that a tool supposedly measuring depression is actually measuring depression, rather than aspects of a physical illness.

And then they leapt to a conclusion that surely can't be justified on the basis of this one study.
 
This seems deceitful to me, unless I've misunderstood something.

Scenario : Patient visits doctor about, say, non-resolving belly pain. Doctor takes patient's blood pressure a few times and decides that the patient is faking it. Patient is dismissed on the basis of a BP measurement with their belly pain unresolved. I can see this will save money, but won't actually cure anybody of anything. What is the point of doctors going to work in the morning if they always do bugger all?
 
The level of confusion here is frankly excessive. The uncertainty value of those results is essentially infinity.

Just throw dice at this point, no functional difference.

Honestly funding for medical research is completely broken. This has no possible value and is just a jumble of weird beliefs with no coherent sense or reason.
 
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