Four complementary causal analysis methods explore whether Oura biometrics
shifted after ruxolitinib
(10 mg BID, started 2026-03-16) on Oura Ring biometrics.
Data period: 2026-01-08 to 2026-03-23
(75 days).
Warning: Post-intervention period is very short (8 days).
Results should be interpreted with caution. Minimum 14-21 days of post-intervention data recommended.
Post-intervention
Insufficient8days
Lowest raw p
Not significantp=1.000
N/A | q=1.0000
4
CI + PCMCI+ + TE + Mediation
1. CausalImpact - Bayesian Structural Time Series Analysis
Method: Bayesian Structural Time Series (BSTS) models pre-intervention dynamics and generates a counterfactual prediction for the post-period. The difference between actual and counterfactual estimates the causal effect, with full posterior uncertainty. MCMC: 5,000 iterations, weekly seasonal component (nseasons=7). Benjamini-Hochberg FDR correction for multiple testing.
FAILED CausalImpact package not installed. Install with: pip install pycausalimpact
1a. Statistical Power & Interpretation
Purpose: All 11 metrics sorted by statistical significance, with Benjamini-Hochberg corrected q-values for multiple testing.
No CausalImpact results available for statistical power analysis.
1b. Placebo tests (intervention date falsification)
Method: CausalImpact is run with 3 random placebo dates in the pre-period on the 3 most significant metrics. Placebo dates should NOT show significant effects.
CausalImpact failed, skipping placebo
2. Granger Causality Network (PCMCI+)
Method: PCMCI+ (tigramite) tests for time-lagged causal relationships between biometric variables using partial correlation. Tau_max = 7 days.
Full period (0 days): No significant causal links found.
Pre-ruxolitinib (0 days): No significant causal links found.
3. Transfer Entropy
Method: Transfer entropy quantifies directional information flow between biometric streams. Comparison of TE matrices for pre- and full period reveals changes in information coupling after ruxolitinib start.
Full period (67 days)
| Source | Target | TE (bits) | Net TE |
|---|
| TotalSleep | LowestHR | 0.5057 | +0.1814 |
| DeepDur | LowestHR | 0.5057 | +0.1932 |
| RMSSDmax | LowestHR | 0.5057 | +0.2439 |
| SpO2 | LowestHR | 0.5057 | +0.0548 |
| TempDev | LowestHR | 0.5057 | +0.1932 |
| REMdur | RespRate | 0.5041 | +0.1875 |
| TotalSleep | RespRate | 0.5041 | +0.1798 |
| DeepDur | RespRate | 0.5041 | +0.1916 |
Pre-ruxolitinib (60 days)
| Source | Target | TE (bits) | Net TE |
|---|
| REMdur | RespRate | 0.4826 | +0.1887 |
| REMpct | RespRate | 0.4826 | +0.2721 |
| TotalSleep | RespRate | 0.4826 | +0.3072 |
| DeepDur | RespRate | 0.4826 | +0.1536 |
| RMSSD | RespRate | 0.4826 | +0.0920 |
| RMSSDmax | RespRate | 0.4826 | +0.2721 |
| LowestHR | RespRate | 0.4826 | +0.0834 |
| AvgHR | RespRate | 0.4826 | +0.1686 |
Change in information flow
Largest increase: REMdur -> TotalSleep (+0.1489 bits)
Largest decrease: REMpct -> TempDev (-0.0649 bits)
5. Clinical Interpretation
Executive summary
N/A
Strongest signal: p=1.000
0/0
Metrics trending in expected direction
8
Post-intervention days (Day 14 target)
- N/A: strongest hypothesis-generating raw p-value signal
(p=1.0000, q=1.0000). It does not survive
FDR correction, so confirmation still depends on more post-treatment follow-up.
- CausalImpact: 0 of 0 biometric streams show
significant causal change (p < 0.05). After Benjamini-Hochberg FDR correction:
0 of 0 remain significant (q < 0.05).
- Placebo validation: N/A - ?/?
placebo tests reached significance. This keeps the result vulnerable to false positives
rather than establishing a confirmed intervention effect.
- PCMCI+: 0 significant time-lagged causal links
identified in the biometric network
- Mediation analysis: 0 of 4 mediating pathways
show significant indirect effect
Limitations
- Short post-period (8 days): All results are preliminary.
Minimum 14-21 days of post-intervention data recommended for robust causal inference.
- Confounders: Linear methods cannot capture non-linear interactions.
Seasonal variation, activity level, and other medications are not controlled for.
- Wearable data: Oura Ring is not a medical device.
Measurements have inherent noise that can affect causal estimates.
- Single patient: N=1 study without control group. Causality cannot be
definitively established, but Bayesian posterior probability of effect provides a strength measure.
- HEV diagnosis: HEV was diagnosed 2026-03-18 (2 days after
ruxolitinib start). Hepatitis may confound biometric changes.
Recommendations
- Repeat analysis after 2-3 weeks of ruxolitinib treatment for robust causal inference
- Add HEV-related biomarkers (ALT, bilirubin) as time-varying covariates
- Consider synthetic control method when longer time series are available
- Combine with clinical endpoints (GVHD scoring, ferritin) for multimodal analysis