CoChat
Sign Up
Cited by 57Circadian rhythm and melatoninSleep and Work-Related FatigueSleep and related disorders

Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank

Open access
Brooks, Thomas G., Lahens, Nicholas F., Grant, Gregory R., Sheline, Yvette I., FitzGerald, Garret A., Skarke, Carsten·2023·Nature Communications
DOI 10.1038/s41467-023-40977-5PMC PMC10449859

Published version of a preprint

Open this paper in CoChat — free accountOpen PDF

Abstract

Many chronic disease symptomatologies involve desynchronized sleep-wake cycles, indicative of disrupted biorhythms. This can be interrogated using body temperature rhythms, which have circadian as well as sleep-wake behavior/environmental evoked components. Here, we investigated the association of wrist temperature amplitudes with a future onset of disease in the UK Biobank one year after actigraphy. Among 425 disease conditions (range n = 200-6728) compared to controls (range n = 62,107-91,134), a total of 73 (17%) disease phenotypes were significantly associated with decreased amplitudes of wrist temperature (Benjamini-Hochberg FDR q < 0.05) and 26 (6.1%) PheCODEs passed a more stringent significance level (Bonferroni-correction α < 0.05). A two-standard deviation (1.8° Celsius) lower wrist temperature amplitude corresponded to hazard ratios of 1.91 (1.58-2.31 95% CI) for NAFLD, 1.69 (1.53-1.88) for type 2 diabetes, 1.25 (1.14-1.37) for renal failure, 1.23 (1.17-1.3) for hypertension, and 1.22 (1.11-1.33) for pneumonia (phenome-wide atlas available at http://bioinf.itmat.upenn.edu/biorhythm_atlas/ ). This work suggests peripheral thermoregulation as a digital biomarker.

AI snapshot

Written from the paper’s full text.

TL;DR

In UK Biobank participants with wrist actigraphy, lower diurnal wrist temperature amplitude was associated with future diagnosis of many diseases, including metabolic, cardiovascular, renal, respiratory, and liver conditions. The authors propose peripheral thermoregulation as a potential digital biomarker.

Key findings

  • Among 425 PheCODEs with at least 200 cases, 73 (17%) were significantly associated with decreased wrist temperature amplitude at Benjamini-Hochberg FDR q < 0.05, and 26 (6.1%) passed Bonferroni correction (α < 0.05).
  • A 2 SD lower wrist temperature amplitude (1.8 °C) corresponded to hazard ratios of 1.91 (1.58–2.31 95% CI) for NAFLD, 1.69 (1.53–1.88) for type 2 diabetes, 1.25 (1.14–1.37) for renal failure, 1.23 (1.17–1.30) for hypertension, and 1.22 (1.11–1.33) for pneumonia.
  • Lower amplitude was also associated with increased all-cause mortality: HR = 1.14 (1.04–1.23 95% CI) for a 2 SD decrease, with n = 3061 deaths.
  • Opposite-direction associations occurred for Parkinson’s disease (HR = 0.76 [0.59–0.97], q = 0.11, n = 295) and Raynaud’s syndrome (HR = 0.63 [0.51–0.79], q = 0.001, n = 295).

Methods

  • UK Biobank collected 7 days of wrist actigraphy from 103,688 participants; 91,462 passed quality control and had complete covariate data. Wrist temperature was fit with cosinor models to extract amplitude.
  • Disease phenotypes were derived from inpatient hospital ICD-10 codes grouped into PheCODEs; diagnoses within one year after actigraphy were excluded, and mean follow-up was 5.9 years (4.8–7.3 min-max).
  • Cox proportional hazards models were run for each PheCODE with ≥200 cases, with temperature amplitude as the independent variable and covariates including sex, ethnicity, smoking, age, BMI, education, Townsend deprivation index, alcohol consumption, and self-reported health; multiple testing was controlled by Benjamini-Hochberg FDR.

Limitations

  • The paper states that wrist temperature was measured by a sensor enclosed in the actigraphy device, separated from direct skin contact by a few millimeters of plastic, and that ambient temperature fluctuations should be considered.
  • The paper states that disease phenotypes came from in-patient hospital diagnostic codes, so some phenotypes may be recorded later than actual disease onset or missed entirely; BMI was included as a covariate but measured about five years before actigraphy, serving as an incomplete control; menstrual phase and contraceptive data were lacking, and menopause status was not collected at accelerometry for most participants.
  • The paper also notes that cosine curves do not capture the exact shape of diurnal wrist temperature variation, suggesting future approaches with higher harmonic terms or functional principal component analysis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41467-023-40977-5

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 67 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among 425 disease conditions in the UK Biobank, 73 (17%) disease phenotypes were significantly associated with decreased amplitudes of wrist temperature at a Benjamini-Hochberg false discovery rate q < 0.05.

    “Among 425 disease conditions (range n = 200-6728) compared to controls (range n = 62,107-91,134), a total of 73 (17%) disease phenotypes were significantly associated with decreased amplitudes of wrist temperature (Benjamini-Hochberg FDR q < 0.05)”
    • Also stated in: § Biorhythms in wrist temperature associate with future diagnoses · plain
      “Of the 425 PheCODEs with at least 200 cases, a total of 73 (17%) reached significance at a Benjamini-Hochberg false discovery rate (FDR) of q < 0.05 (Fig. 3a, Supplementary Data 1).”
    • Also stated in: § Discussion · plain
      “We identified 73 out of 425 (17%) disease phenotypes across the human phenome that were associated with decreased wrist temperature amplitudes”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The covariates included in the Cox proportional hazards models adequately control for confounding by sleep, ambient temperature, food intake, and other factors that modulate wrist temperature.
    • Rests on an assumption: A one-year latency period is sufficient to exclude participants with subclinical disease at the time of actigraphy.
    • Rests on an assumption: Seven days of wrist temperature recording reliably estimates habitual diurnal temperature amplitude.
  • Findingown data

    Among 425 disease conditions in the UK Biobank, 26 (6.1%) PheCODEs passed a more stringent significance level (Bonferroni-correction α < 0.05).

    “26 (6.1%) PheCODEs passed a more stringent significance level (Bonferroni-correction α < 0.05).”
    • Also stated in: § Biorhythms in wrist temperature associate with future diagnoses · plain
      “The more conservative Bonferroni family-wise error rate (FWER) of α < 0.05, (p < 0.00012, Fig. 3a), identified a total of 26 (6.1%) PheCODEs.”
    • Also stated in: § Discussion · plain
      “26 of which (6.1%) were highly significant under more stringent criteria.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The covariates included in the Cox proportional hazards models adequately control for confounding by sleep, ambient temperature, food intake, and other factors that modulate wrist temperature.
    • Rests on an assumption: A one-year latency period is sufficient to exclude participants with subclinical disease at the time of actigraphy.
    • Rests on an assumption: Seven days of wrist temperature recording reliably estimates habitual diurnal temperature amplitude.
  • Findingown data

    The wrist temperature curves are right shifted for the evening chronotype compared to participants reporting a morning preference.

    “The wrist temperature curves are right shifted for the evening chronotype compared to participants reporting a morning preference (Fig. 2a).”
    Quote in the paperNot a substantial claim
  • Findingcitation

    The shape of the UK Biobank wrist temperature curves matched previously reported curves for peripheral skin measured at the wrist.

    “The shape of the UKBB wrist temperature curves matched previously reported curves for peripheral skin measured at the wrist11.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Sarabia, J. A., Rol, M. A., Mendiola, P. & Madrid, J. A. Circadian rhythm of wrist temperature in normal-living subjects A candidate of new index of the circadian system. Physiol. Behav. 95, 570–580 (2008). source

      Not checked in the free run.

  • Findingown data

    The peripheral skin temperature signal was strong enough to produce a phenotype characteristic of a biological origin.

    “we found that the peripheral skin temperature signal (Supplementary Fig. 1) was strong enough to produce a phenotype characteristic of a biological origin.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 40
  • May combine two claims. 30
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingreasoning

    Mortality associations were not consistently significant among sub cohorts, possibly driven by lower death counts or covariates such as recruitment center.

    “Interestingly, mortality associations were not consistently significant among sub cohorts (see Methods), possibly driven by lower death counts or covariates such as recruitment center.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Trends for sex-dependent differences emerged for several disease phenotypes: hernias, degenerative joint diseases, reflux esophagitis and colorectal cancer showed a weak interaction between sex and wrist temperature amplitude (p < 0.05); however, there was insufficient power to overcome correction for multiple testing (q > 0.5 for all PheCODEs).

    “Trends for sex-dependent differences emerged for several disease phenotypes. Hernias, degenerative joint diseases, reflux esophagitis and colorectal cancer showed a weak interaction between sex and wrist temperature amplitude (p < 0.05); however, to the extent that these are real, there was insufficient power to overcome correction for multiple testing (q > 0.5 for all PheCODEs).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The covariates included in the Cox proportional hazards models adequately control for confounding by sleep, ambient temperature, food intake, and other factors that modulate wrist temperature.
    • Rests on an assumption: A one-year latency period is sufficient to exclude participants with subclinical disease at the time of actigraphy.
    • Rests on an assumption: Seven days of wrist temperature recording reliably estimates habitual diurnal temperature amplitude.

  • May combine two claims.

    Findingcitation

    The accelerometry trace in Parkinson's patients indicated lower diurnal variation and physical activity, an observation associated with elevated risk of disease.

    “The accelerometry trace in Parkinson’s patients indicated lower diurnal variation and physical activity (Supplementary Fig. 3), an observation associated with elevated risk of disease43.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Xu, Q. et al. Physical activities and future risk of Parkinson disease. Neurology 75, 341–348 (2010). source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    No phenotypes displayed significant differences by sex or by age after correction for multiple testing (q ≥ 0.48 for all phenotypes).

    “No phenotypes displayed significant differences by sex or by age after correction for multiple testing (q ≥ 0.48 for all phenotypes).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only 2 individuals out of 92,322 exceeded the 10 degrees Celsius threshold and were dropped; only 28 exceeded 6 degrees Celsius, indicating non-physiological effects are likely not a large influence.

    “Anyone with a reported temperature amplitude above 10 degrees Celsius was dropped as being non-physiological. Only 2 individuals (out of 92,322) exceeded this threshold and were dropped from further analysis. Furthermore, only 28 subjects exceed a more stringent threshold of 6 degrees Celsius, indicating that non-physiological effects are likely not a large influence.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Cosinor amplitude of temperature measures are robust and show little device-specific bias.

    “However, the cosinor amplitude of temperature measures are robust and show little device-specific bias, Supplementary Fig. 4c.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In a small set of subjects recalled for imaging at around the same time as actigraphy, about 95% of females were post-menopausal.

    “In a small set of subjects recalled for imaging at around the same time as the actigraphy was taken, about 95% of females were post-menopausal.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Device ID clusters were identified with distinctly different values; clusters were associated with season of measurement but not with sex, BMI, birth year, or Townsend deprivation index.

    “We identified three “clusters” of device ids with distinctly different values reported, Supplementary Fig. 4 top.”
    • Also stated in: § Wrist temperature · plain
      “We observed that these clusters were associated with season of measurement but not with other covariates such as sex, BMI, birth year, or Townsend deprivation index.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    A total of 451,994 distinct patient diagnoses and 3,061 deaths were recorded among participants at data download.

    “A total of 451,994 distinct patient diagnoses (mean 4.9 per participant) and 3,061 deaths (3.3%) were recorded among these participants at the time of data download on February 23, 2022 (Fig. 1a).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Mean temperature shows strong device-specific bias, indicating a lack of temperature-sensor calibration.

    “The mean temperature shows strong device-specific bias, Supplementary Fig. 4c, indicating a lack of temperature-sensor calibration.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The overall correlation between physical activity and wrist temperature was weak (Spearman r = 0.21), indicating temperature is a distinct measure despite being recorded from the same device as motion.

    “The overall correlation between physical activity and wrist temperature was weak (Spearman r = 0.21), indicating that temperature is a distinct measure despite being recorded from the same device as motion.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All-cause mortality had p = 0.4 in cohort B + C, but showed consistent effect direction (HR = 0.031 per degree C decrease, n = 911 deaths) with the full cohort and cohort A.

    “Notably, all-cause mortality had p = 0.4 in the cohort B + C, though it showed consistent effect direction (HR = 0.031 per degree C decrease, n = 911 deaths) with the full cohort and cohort A.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Essential hypertension had hazard ratios of 1.23 (1.17-1.3) in the full cohort, 1.22 (1.14-1.30) in sub cohort A, and 1.26 (1.15-1.38) in sub-cohort B + C.

    “For example, essential hypertension has HR of 1.23 (1.17–1.3 95% CI) in the full cohort, 1.22 (1.14–1.30) in sub cohort A and 1.26 (1.15–1.38) in sub-cohort B + C.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The UK Biobank collected 7 days of actigraphy from 103,688 participants, with 91,462 participants passing quality control and having all covariates.

    “The UKBB collected 7 days of actigraphy from 103,688 participants (Fig. 1)20, with 91,462 participants passing quality control and having all covariates.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Doherty, A. et al. Large Scale Population Assessment of Physical Activity Using Wrist Worn Accelerometers: The UK Biobank Study. PLoS ONE 12, e0169649 (2017). source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The role biorhythms play as biomarkers for disease onset is less well understood.

    “The role biorhythms play as biomarkers for disease onset is less well understood6.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Fitzgerald, G. A., Yang, G., Paschos, G. K., Liang, X. & Skarke, C. Molecular clocks and the human condition: approaching their characterization in human physiology and disease. Diabetes Obes. Metab. 17, 139–142 (2015). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The wrist temperature shape has been described as running phase-advanced or inverse (anti-phase) to core body temperature and to activity.

    “This shape has been described as running phase-advanced or inverse (anti-phase) to the core body temperature21 and to activity (Supplementary Fig. 3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Krauchi, K. & Wirz-Justice, A. Circadian rhythm of heat production, heart rate, and skin and core temperature under unmasking conditions in men. Am. J. Physiol. 267, R819–R829 (1994).

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The relationship of cooling down the body core temperature by peripheral vasodilation resulting in heat loss has been proposed as a thermoregulatory mechanism to induce sleep.

    “The relationship of cooling down the body core temperature by peripheral vasodilation resulting in heat loss has been proposed as a thermoregulatory mechanism to induce sleep22.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Raymann, R. J., Swaab, D. F. & Van Someren, E. J. Cutaneous warming promotes sleep onset. Am. J. Physiol. Regul. Integr. Comp. Physiol. 288, R1589–R1597 (2005). source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Roughly 3.5 °C of the peak-to-trough oscillations are driven by the circadian clock, and the remainder of about 1.5-2 °C is likely driven by behavioral and environmental components.

    “Roughly 3.5 °C of these peak-to-through oscillations are driven by the circadian clock21, the remainder of about 1.5–2 °C is likely driven by behavioral and environmental components.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Krauchi, K. & Wirz-Justice, A. Circadian rhythm of heat production, heart rate, and skin and core temperature under unmasking conditions in men. Am. J. Physiol. 267, R819–R829 (1994).

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Shift work reduces the amplitude of temperature rhythms.

    “Shift work reduces the amplitude of temperature rhythms14”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Jang, T. W. et al. Circadian rhythm of wrist temperature among shift workers in South Korea: a prospective observational study. Int. J. Environ. Res. Public Health 14, 1109 (2017). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Disruption of temperature rhythms has been strongly associated with sleep-disordered breathing.

    “as well as sleep-disordered breathing16.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Martinez-Nicolas, A. et al. Circadian impairment of distal skin temperature rhythm in patients with sleep-disordered breathing: the effect of CPAP. Sleep 40, zsx067 (2017). source

      Not checked in the free run.

  • The quote only partly states this claim.

    Interpretationcitation

    The association between low wrist temperature amplitude and NAFLD corroborates the known loss in diurnal variance of distal skin temperature in cohorts of patients with liver cirrhosis compared to controls.

    “This corroborates the known loss in diurnal variance of distal skin temperature in cohorts of patients with liver cirrhosis compared to controls28.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Garrido, M. et al. Abnormalities in the 24-hour rhythm of skin temperature in cirrhosis: sleep-wake and general clinical implications. Liver Int. 37, 1833–1842 (2017). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Diurnal variation in dopamine neurotransmission is well known with evidence for functional consequences.

    “Diurnal variation in dopamine neurotransmission is well known35 with evidence for functional consequences.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Ferris, M. J. et al. Dopamine transporters govern diurnal variation in extracellular dopamine tone. Proc. Natl Acad. Sci. USA 111, E2751–E2759 (2014). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Onset of diabetes has long been associated with circadian clock disruption.

    “Onset of diabetes has long been associated with circadian clock disruption31.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Stenvers, D. J., Scheer, F., Schrauwen, P., la Fleur, S. E. & Kalsbeek, A. Circadian clocks and insulin resistance. Nat. Rev. Endocrinol. 15, 75–89 (2019). source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    To exclude participants with subclinical disease at the time of actigraphy, enrollment was limited to those whose first recorded diagnostic event was at least one year after actigraphy.

    “To exclude participants with subclinical disease at the time of actigraphy, we limited enrollment to those participants whose first recorded diagnostic event was at least one year after their actigraphy assay.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The resulting reduction in the distal temperature amplitude has been observed in diabetic patients before polyneuropathy manifested, suggesting that altered peripheral temperature rhythms identify patients early at risk of disease progression.

    “The resulting reduction in the distal temperature amplitude has been observed in diabetic patients before polyneuropathy manifested32, suggesting that altered peripheral temperature rhythms identify patients early at risk of disease progression.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Rutkove, S. B. et al. Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32, 671–676 (2009). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Psychiatric disorders are commonly associated with altered circadian rhythms.

    “Psychiatric disorders are commonly associated with altered circadian rhythms38.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Walker, W. H. 2nd, Walton, J. C., DeVries, A. C. & Nelson, R. J. Circadian rhythm disruption and mental health. Transl. Psychiatry 10, 28 (2020).

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    By introducing a latency period of one year, we eliminated potentially undiagnosed mild or subclinical disease conditions present during the monitoring period which might have had a dampening effect on the temperature rhythms.

    “By introducing a latency period of one year, we eliminated potentially undiagnosed mild or subclinical disease conditions present during the monitoring period which might have had a dampening effect on the temperature rhythms.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Age, fitted as a linear relationship with the outcome, was controlled in the mortality model.

    “Age, fitted as a linear relationship with the outcome, was controlled in that model.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Both Parkinson's disease and Raynaud's syndrome are marked by impaired thermoregulation, linked in Parkinson's to alpha-synuclein pathology in the CNS and in Raynaud's to sympathetic nervous system and α2C adrenoreceptor dysregulation in the small blood vessels of the digits.

    “However, both of these diseases are marked by impaired thermoregulation39,40, linked in Parkinson’s to alpha-synuclein pathology in the CNS40 and in Raynaud’s to sympathetic nervous system and α2C adrenoreceptor dysregulation in the small blood vessels of the digits41.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [39] Coon, E. A. & Low, P. A. Thermoregulation in Parkinson disease. Handb. Clin. Neurol. 157, 715–725 (2018). source

      Not checked in the free run.

    • cites [40] Greenstein, D., Gupta, N. K., Martin, P., Walker, D. R. & Kester, R. C. Impaired thermoregulation in Raynaud’s phenomenon. Angiology 46, 603–611 (1995). source

      Not checked in the free run.

    • cites [41] Fardoun, M. M., Nassif, J., Issa, K., Baydoun, E. & Eid, A. H. Raynaud’s phenomenon: a brief review of the underlying mechanisms. Front Pharm. 7, 438 (2016). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The distal-proximal temperature gradient indicative of heat dissipation is blunted, which contributes to the highly prevalent sleep disruptions reported for cirrhotic patients.

    “Consequently, the distal-proximal temperature gradient indicative of heat dissipation is blunted, which contributes to the highly prevalent sleep disruptions reported for cirrhotic patients29, among other proposed mechanisms such as displaced melatonin secretion30.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [29] Cordoba, J. et al. High prevalence of sleep disturbance in cirrhosis. Hepatology 27, 339–345 (1998). source

      Not checked in the free run.

    • cites [30] Steindl, P. E. et al. Disruption of the diurnal rhythm of plasma melatonin in cirrhosis. Ann. Intern. Med. 123, 274–277 (1995). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The relationship between wrist temperature and extrapyramidal disease is likely modulated by the high degree of inter-individual variability in dopamine D2 receptor density, which, with its role in central thermoregulation, may lead to the high association of wrist temperature for susceptibility to extrapyramidal disease.

    “This relationship is likely modulated by the high degree of inter-individual variability in dopamine D2 receptor density37, which, with its role in central thermoregulation, may lead to the high association of wrist temperature for susceptibility to extrapyramidal disease.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Farde, L., Hall, H., Pauli, S. & Halldin, C. Variability in D2-dopamine receptor density and affinity: a PET study with [11C]raclopride in man. Synapse 20, 200–208 (1995). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Menstrual phases modulate peripheral temperature readings.

    “Menstrual phases modulate peripheral temperature readings60, but the lack of contraceptive or menstrual cycle phase data precluded any further analyses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Baker, F. C., Siboza, F. & Fuller, A. Temperature regulation in women: effects of the menstrual cycle. Temperature 7, 226–262 (2020). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Thermogenic and heat-dissipative processes modulate the set point throughout the course of 24 hours typically resulting in peak core temperatures in the afternoon with the nadir reached at the end of the sleeping phase.

    “Thermogenic and heat-dissipative processes modulate the set point throughout the course of 24 hours typically resulting in peak core temperatures in the afternoon with the nadir reached at the end of the sleeping phase11.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Sarabia, J. A., Rol, M. A., Mendiola, P. & Madrid, J. A. Circadian rhythm of wrist temperature in normal-living subjects A candidate of new index of the circadian system. Physiol. Behav. 95, 570–580 (2008). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    As this relationship is driven by circadian, sleep-wake behavior and environmental components, interventions may target different aspects.

    “As this relationship is driven by circadian, sleep-wake behavior and environmental components, interventions may target different aspects.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A device worn on the wrist sufficiently captures the biological signal and is little contaminated by ambient temperature.

    “suggesting that a device worn on the wrist sufficiently captures the biological signal and is little contaminated by ambient temperature32”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Rutkove, S. B. et al. Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32, 671–676 (2009). source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Temperature amplitude was corrected by multiplicative scaling of each cluster to equalize medians.

    “The temperature amplitude was corrected by a multiplicative scaling of each cluster such that the median of each cluster was set to be equal to the overall median.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Repeated measurements across seasons were collected for 3197 participants and leveraged to account for seasonality and determine variance of temperature amplitudes.

    “In addition, repeated measurements across seasons were collected for 3197 participants. This data is available but has not yet been reported on in detail. We leveraged these repeated datasets to account for seasonality across participants and to determine the variance of temperature amplitudes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A Cox proportional hazards model was performed for each PheCODE with at least 200 cases, based on a power analysis to establish a 0.2 log hazard ratio effect at 80% power.

    “A Cox proportional hazards model was performed for each PheCODE with ≥200 cases, based on a power analysis performed via simulation to establish a 0.2 log (hazard ratio) effect size at 80% power.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Temperature-dependent polyadenylation through RBM3, a cold-inducible RNA-binding protein, has been suggested to contribute to cell reprogramming during a stress response.

    “Temperature-dependent polyadenylation through RBM3, a cold-inducible RNA-binding protein, has been suggested to contribute to cell reprogramming during a stress response55,56.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [55] Ki, Y. et al. Warming up your tick-tock: temperature-dependent regulation of circadian clocks. Neuroscientist 21, 503–518 (2015). source

      Not checked in the free run.

    • cites [56] Liu, Y. et al. Cold-induced RNA-binding proteins regulate circadian gene expression by controlling alternative polyadenylation. Sci. Rep. 3, 2054 (2013).

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a mouse model, about 10% of rhythmically expressed liver genes were not under control of hepatocyte clocks but instead relied on oscillatory systemic signals.

    “This was suggested in a mouse model, engineered to differentiate between central and peripheral entrainment cues, where the authors showed that about 10% of rhythmically expressed liver genes were not under control of hepatocyte clocks but instead relied on oscillatory systemic signals54.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Kornmann, B., Schaad, O., Bujard, H., Takahashi, J. S. & Schibler, U. System-driven and oscillator-dependent circadian transcription in mice with a conditionally active liver clock. PLoS Biol. 5, e34 (2007). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Overexpression of uncoupling protein 2 in hypocretin neurons (Hcrt-UCP2) of these animals reduced core body temperature by 0.3-0.5 °C accompanied by a presumable increase in peripheral temperature through the coupling of core and periphery in the thermoregulatory sleep model.

    “And overexpression of uncoupling protein 2 in hypocretin neurons (Hcrt-UCP2) of these animals reduced core body temperature by 0.3–0.5 °C accompanied (though this was not measured) by a presumable increase in peripheral temperature through the coupling of core and periphery in the thermoregulatory sleep model10.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Krauchi, K. The human sleep-wake cycle reconsidered from a thermoregulatory point of view. Physiol. Behav. 90, 236–245 (2007). source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Disease phenotypes are collected from in-patient hospital diagnostic codes.

    “A second limitation is that disease phenotypes are collected from in-patient hospital diagnostic codes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Some phenotypes may be recorded significantly later than actual disease onset and others may be missed from the dataset entirely.

    “Therefore, some phenotypes may be recorded significantly later than actual disease onset and others may be missed from the dataset entirely.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    A complete-case analysis was performed on 91,462 subjects with complete data.

    “A complete-case analysis was performed on 91,462 subjects with complete data (Fig. 1b).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Lack of contraceptive or menstrual cycle phase data precluded further analyses.

    “but the lack of contraceptive or menstrual cycle phase data precluded any further analyses.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    A further 873 subjects were excluded for missing covariate data, leaving 91,462 with no missing data selected for analysis.

    “A further n = 873 subjects were excluded for missing data from the covariates for a total of 91,462 with no missing data who were thus selected for analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Core and peripheral body temperature are inversely coupled to regulate body temperature by balancing heat production and loss.

    “Core and peripheral body temperature are inversely coupled to regulate body temperature by balancing heat production and loss10,11.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] Krauchi, K. The human sleep-wake cycle reconsidered from a thermoregulatory point of view. Physiol. Behav. 90, 236–245 (2007). source

      Not checked in the free run.

    • cites [11] Sarabia, J. A., Rol, M. A., Mendiola, P. & Madrid, J. A. Circadian rhythm of wrist temperature in normal-living subjects A candidate of new index of the circadian system. Physiol. Behav. 95, 570–580 (2008). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The circadian aspect of thermoregulation is achieved through diurnal oscillations of the temperature set point in the hypothalamic preoptic area and controlled by the 'master' clock in the suprachiasmatic nucleus (SCN).

    “The circadian aspect of thermoregulation is achieved through diurnal oscillations of the temperature set point in the hypothalamic preoptic area and controlled by the ‘master’ clock in the suprachiasmatic nucleus (SCN)53.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Krauchi, K. The thermophysiological cascade leading to sleep initiation in relation to phase of entrainment. Sleep. Med. Rev. 11, 439–451 (2007). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Excluding subjects according to prior diagnoses of any related disease partially corrected for phenotype misclassification.

    “This was partially corrected for by excluding subjects according to prior diagnoses of any related disease, derived from including self-reported medical conditions at the initial assessment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Temperature traces in the UK Biobank study capture biological signal compellingly and agree with field studies.

    “Our results indicate that the temperature traces in the UKBB study capture biological signal compellingly and agree with field studies13,23,32.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [13] Bonmati-Carrion, M. A. et al. Circadian phase assessment by ambulatory monitoring in humans: correlation with dim light melatonin onset. Chronobiol. Int. 31, 37–51 (2014). source

      Not checked in the free run.

    • cites [23] Capella, M. D. M., Martinez-Nicolas, A. & Adan, A. Circadian rhythmic characteristics in men with substance use disorder under treatment. influence of age of onset of substance use and duration of abstinence. Front. Psychiatry 9, 373 (2018). source

      Not checked in the free run.

    • cites [32] Rutkove, S. B. et al. Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32, 671–676 (2009). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    Cosine curves do not capture the exact shape of diurnal wrist temperature variation.

    “Lastly, since cosine curves do not capture the exact shape of diurnal wrist temperature variation, future approaches could include using higher harmonic terms61 or highly flexible approaches such as functional principal component analysis62.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    These oscillatory temperature cues are likely picked up in the periphery to entrain, for example, sets of hepatic gene transcripts independent of peripheral liver clocks.

    “These oscillatory temperature cues are likely picked up in the periphery to entrain, for example, sets of hepatic gene transcripts independent of peripheral liver clocks54.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Kornmann, B., Schaad, O., Bujard, H., Takahashi, J. S. & Schibler, U. System-driven and oscillator-dependent circadian transcription in mice with a conditionally active liver clock. PLoS Biol. 5, e34 (2007). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Reported temperature values match those used in a prior thorough investigation which corrected a flaw in earlier processing pipelines.

    “This makes our reported values match those used in a prior, thorough investigation of these temperature values17 which corrected a flaw in earlier processing pipelines.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Kennard, H. R., Huebner, G. M., Shipworth, D. & Oreszczyn, T. The associations between thermal variety and health: Implications for space heating energy use. PLoS ONE 15, e0236116 (2020). source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Diagnosis events were assessed starting one year after actigraphy, with a mean follow-up time of 5.9 years.

    “Diagnosis events were assessed in subjects starting one year after actigraphy, for a mean follow-up time of 5.9 years (4.8–7.3 min-max), see Figure1a.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A total of 92,325 participants passed quality control after exclusions based on failed calibration, insufficient data, or crossing over daylight savings time.

    “A total of 92,325 participants passed quality control after exclusions based on failed calibration (n = 2826), insufficient data (n = 4258) or crossing over daylight savings time (n = 4279), following prior experiments7,8,20.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Ferguson, A. et al. Genome-Wide Association Study of Circadian Rhythmicity in 71,500 UK Biobank Participants and Polygenic Association with Mood Instability. EBioMedicine 35, 279–287 (2018). source

      Not checked in the free run.

    • cites [8] Lyall, L. M. et al. Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91 105 participants from the UK Biobank. Lancet Psychiatry 5, 507–514 (2018). source

      Not checked in the free run.

    • cites [20] Doherty, A. et al. Large Scale Population Assessment of Physical Activity Using Wrist Worn Accelerometers: The UK Biobank Study. PLoS ONE 12, e0169649 (2017). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationcitation

    An explanation for some of the strong associations observed in this study might be that small amplitude temperature rhythms diminish thermosensitive gene regulation, which in combination with disease-specific perturbations, like those observed for diabetic neuropathy, lead to the emergence of specific disease phenotypes.

    “An explanation for some of the strong associations observed in this study might be that small amplitude temperature rhythms diminish thermosensitive gene regulation, which in combination with disease-specific perturbations, like those observed for diabetic neuropathy,32,33 lead to the emergence of specific disease phenotypes.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [32] Rutkove, S. B. et al. Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32, 671–676 (2009). source

      Not checked in the free run.

    • cites [33] Barone, M. T. U., Goncalves, B. & Menna-Barreto, L. Peripheral body temperature impairment in individuals with type 1 diabetes mellitus. Sleep. Sci. 11, 137–140 (2018). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cosinor fits have been validated for use in measuring rhythms in both distal skin temperature and core body temperature.

    “Cosinor fits have been validated for use in measuring rhythms in both distal skin temperature and core body temperature14,67.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Jang, T. W. et al. Circadian rhythm of wrist temperature among shift workers in South Korea: a prospective observational study. Int. J. Environ. Res. Public Health 14, 1109 (2017). source

      Not checked in the free run.

    • cites [67] Culver, A. et al. Circadian disruption of core body temperature in trauma patients: a single-center retrospective observational study. J. Intensive Care 8, 4 (2020). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    All covariates were assessed at initial enrollment, a mean of 5.7 years before actigraphy collection.

    “All covariates were assessed at initial enrollment in the UKBB, which had a mean of 5.7 (2.8–8.7 min-max) years before actigraphy collection.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Model assumptions were assessed, and results were confirmed to show only small changes in hazard ratios of wrist temperature amplitude after time-interaction, spline, and competing-risk models.

    “All results were confirmed to show only small changes in hazard ratios of the wrist temperature amplitude compared to the original model (see Supplementary Data 2).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    P-values were adjusted as Benjamini-Hochberg q-values to control the false discovery rate.

    “To control for the large number of statistical tests performed, p-values have been adjusted where appropriate as Benjamini-Hochberg q-values to control the false discovery rate.”
    Quote in the paperSubstantial claim
60 of 60

  • The paper relies on this without support.

    The covariates included in the Cox proportional hazards models adequately control for confounding by sleep, ambient temperature, food intake, and other factors that modulate wrist temperature.

    “This wrist temperature signal was clearly discernable despite it being modulated (masked) by sleep, ambient temperature conditions, food intake and other confounders.”
    “with 91,462 participants passing quality control and having all covariates.”

  • The paper relies on this without support.

    A one-year latency period is sufficient to exclude participants with subclinical disease at the time of actigraphy.

    “To exclude participants with subclinical disease at the time of actigraphy, we limited enrollment to those participants whose first recorded diagnostic event was at least one year after their actigraphy assay.”

  • The paper relies on this without support.

    Seven days of wrist temperature recording reliably estimates habitual diurnal temperature amplitude.

    “The UKBB collected 7 days of actigraphy from 103,688 participants (Fig. 1)20”

  • The paper relies on this without support.

    The UK Biobank cohort is representative enough for the associations to generalize to the general population.

    “Among 425 disease conditions (range n = 200-6728) compared to controls (range n = 62,107-91,134), a total of 73 (17%) disease phenotypes were significantly associated with decreased amplitudes of wrist temperature”

  • The paper relies on this without support.

    Disease phenotypes derived from in-patient hospital diagnostic codes accurately reflect disease onset and presence.

    “A second limitation is that disease phenotypes are collected from in-patient hospital diagnostic codes. Therefore, some phenotypes may be recorded significantly later than actual disease onset and others may be missed from the dataset entirely.”

  • The paper relies on this without support.

    The one-year lag period is sufficient to exclude prevalent disease cases.

    “Diagnosis events were assessed in subjects starting one year after actigraphy”
    “All subjects meeting any of the exclusion diagnoses for a phenotype at the end of the one-year lag period (i.e., one year after actigraphy) were excluded from the analysis of that phenotype as likely or potential prior cases.”

  • The paper relies on this without support.

    The PheCODE exclusion criteria correctly identify prior cases of the phenotype.

    “The PheCODE Map provides, for each phenotype, exclusion criteria denoting similar conditions that may indicate likelihood of undiagnosed patients of the phenotype under consideration.”

  • The paper relies on this without support.

    Complete-case analysis does not introduce bias.

    “A further n = 873 subjects were excluded for missing data from the covariates for a total of 91,462 with no missing data who were thus selected for analysis.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Neither prior literature was able to test their efficacy in large, real-world cohorts representing a practical assessment.

    “Though interesting, neither literature was able to test their efficacy in large, real-world cohorts representing a practical assessment.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [38]

    The Methods (Actigraphy in the UK Biobank; Proportional hazards models) describe an analysis of 91,462 UK Biobank participants, directly contrary to the claim that this work did not assess its approach in a large, real-world cohort. The paper tests associations between wrist-temperature rhythms and future disease, rather than the efficacy of an intervention. (LLM, conf=0.84)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Diurnal features of distal and core body temperature are associated with future disease risk for a breadth of conditions, including Type 2 Diabetes.

    “Diurnal features of distal and core body temperature have been central to analyses of circadian rhythm33,34; studied as measures for fever, depression, muscular work33,35–37; and revealed to be associated with future disease risk for a breadth of conditions (including Type 2 Diabetes) in a study of the UKBioBank38.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [38]

    The Introduction reports that diurnal wrist-temperature amplitude in the UK Biobank was associated with future diagnoses across many conditions, including type 2 diabetes. The study measured peripheral wrist temperature, however; its discussion of core temperature does not establish an association between core-temperature features and future disease risk. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Commonly used features are supported by prior work to be relevant to the effects of DM.

    “commonly used features supported by prior work to be relevant to the effects of DM31–33,35–38,45,49”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [38]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Table describes nonsignificant phenotypes as significant

    Minor

    The Table 1 note calls its twelve listed effect sizes significant, but the figure caption explicitly says two listed phenotypes, anxiety disorders and Parkinson's disease, exceed the stated q < 0.05 threshold.

  • Mortality model age specification conflicts with the stated model

    Minor

    The mortality result says age was fitted linearly, but Methods says survival analysis used the same model specified with categorical age bands.

  • Subcohort mortality hazard ratio reverses the reported direction

    Minor

    An HR of 0.031 per degree Celsius decrease indicates lower mortality risk with lower amplitude, whereas the full-cohort result reports increased mortality risk with lower amplitude. The statement that the effect direction is consistent therefore conflicts with the reported HR.

3 of 3

The citation lists haven’t been fetched yet

References 91 · Cited by 57

Authors
Brooks, T. G., Lahens, N. F., Grant, G. R., Sheline, Y. I., FitzGerald, G. A., & Skarke, C.
Affiliations
University of Pennsylvania (US)
Corresponding author
  • Brooks, Thomas G.
  • Skarke, Carsten
ORCID
Venue
Nature Communications
Publisher
Springer Science and Business Media LLC
Published
2023-08-24
Volume
14
Issue
1
Pages
5172-5172
ISSN
2041-1723 (ISSN-L)
DOI
10.1038/s41467-023-40977-5
PMC
PMC10449859
OpenAlex
W4386135039
Semantic Scholar
6bdf92861cd7e14d57fae2213be92625ef7d7656
Cited by
57
References
91
Citations by year
2026: 18 · 2025: 19 · 2024: 16 · 2023: 4
FWCI
8.47
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Communications (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • American Heart Association (17MERIT33560013)
  • Robert L. McNeil Jr. Fellow in Translational Medicine and Therapeutics
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
wrist temperature, diurnal cycle, circadian rhythm, disease risk prediction, actigraphy, digital biomarkers, non-alcoholic fatty liver disease, type 2 diabetes, renal failure, hypertension, pneumonia, UK Biobank

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review