Ernesto Ramirez

March 6, 2014

Mark Drangsholt has been dealing with an issue with his heart since he was a young man. Since his early twenties, when he as diagnosed with paroxysmal atrial tachycardia he’s had to deal with irregular heart rhythms. In this talk Mark explains how the transition into adulthood negatively impacted his health and then how he used self-tracking and a focused athletic program to help him reduce his weight and improve his health. Most show&tell talks would end there, but Mark still had the irregular rhythm issue to deal with. After what he describes as an episode that made him think, “This is it. I’m going to die.” he decided it was time to apply his self-tracking process in order to understand his heart rhythm disorder and possible triggers. Mark also decided to go one step further and apply the principles of case-crossover design to his tracking methodology. Watch his talk below and keep reading to learn a bit more about why you might want to consider using case-crossover design in your self-tracking projects and experiments.

The following excerpt from the QS Primer: Case-Crossover Design by Gary Wolf provides a great background for his method:

Mark’s self-tracking data didn’t naturally fit with any of these approaches. To understand whether these triggers actually had an effect on his arrhythmias, he used a special technique originally proposed by the epidemiologists Murray Mittleman and K. Malcolm Maclure. A case-crossover design is a scientific way to answer the question: “Was the patient doing anything unusual just before the onset of the disease?” It is a design that compares the exposure to a certain agent during the interval when the event does not occur to the exposure during the interval when the event occurs.

Using this method, Mark discovered that events linked to his attacks included high intensity exercise, afternoon caffeine, public speaking to large groups, and inadequate sleep on the previous night. While these were not surprising discoveries, it was interesting to him to be able to rigorously analyze them, and see his intuition supported by evidence. “A citizen scientist isn’t even on the conventional evidence pyramid,” Mark notes. “But you can structure a single subject design to raise the level of evidence and it will be more convincing.”