Ruxolitinib Forecast — Oura Digital Twin

Oura Ring Gen 4 sensor data — not clinical measurementsN=1 case study — not validated for clinical decisionsHEV diagnosed Mar 18; interpret findings cautiously in this Day 72 post-ruxolitinib window

HRV (7-DAY)

Low

27.9ms

Target: 15 ms ESC threshold

Average RMSSD over past 7 nights

LOWEST HR (7-DAY)

Normal

66.3bpm

Target: <70 bpm

Mean lowest heart rate over past 7 nights

DAYS ON RUX

Info

73days

Since 2026-03-16

Days since ruxolitinib initiation

FIRST TARGET ETA

Info

Already met

HRV reaching ESC 15 ms threshold

Expected date based on current trajectory

Forecast Summary

Treatment duration: 73 days on ruxolitinib

HRV (RMSSD) Forecast:
• Current 7-day mean: 27.9 ms (slope: +2.28 ms/week, R²=0.321)
• Best model: exponential
• ESC Threshold (15 ms): Already met
• HSCT Range Low (25 ms): Already met
• Population 25th pct (36 ms): 2026-05-29 (50-95% CI: 2026-05-29 to 2026-06-24)

Heart Rate Forecast:
• Current 7-day mean lowest HR: 66.3 bpm (slope: -1.58 bpm/week)
• Normal (<70 bpm): Already met
• Good (<65 bpm): 2026-04-23
• Excellent (<60 bpm): 2026-05-16

HRV & HR Trajectories with Forecast

Milestone Timeline

Model Comparison: Linear vs Exponential (HRV)

Three-Phase Recovery Context

Methodology & Caveats

Data: 66 post-ruxolitinib HRV observations, 66 post-ruxolitinib HR observations from Oura Ring Gen 4 (consumer wearable, not clinical-grade).

Linear model: OLS regression on day number since treatment start (2026-03-16). Bootstrap: 1000 resamples for confidence intervals.

Exponential model: y = a · (1 - e^-t/τ) + baseline, fit via scipy.optimize.curve_fit with bounded parameters. Model selection by AIC (lower = better).

Three scenarios: Optimistic (75th pct slope), Expected (50th pct), Conservative (25th pct).

Limitations (small N): With only ~66 data points, forecasts carry wide confidence intervals and may shift substantially as more data accumulates. Physiological recovery is non-linear and depends on factors not captured in wearable data (infection status, medication changes, immune reconstitution). These projections are exploratory, not clinical recommendations.