defined by characteristics including ethnicity, culture, and body habitus, to name a
few. Further development of wearable hotflash monitoring devices is also war-
ranted, with refinement of hotflash algorithms to optimally characterize hotflashes.
Recent developments in pattern recognition algorithms for detecting hotflashes in
skin conductance data show promise for improving the utility of these instruments;
however, further validation and dissemination of related software are required.
Researchers are urged to consider mixed-method designs in future research, par-
ticularly in large epidemiologic investigations which could benefit from a subcohort
of participants undergoing more rigorous measures of hotflashes.
We avoid naming one measure of hotflashes as the“gold standard” and
maintain that each measure of hotflashes provides information on a slightly dif-
ferent aspect of hotflashes. Both the subjective experience and the physiologic
measurement of hotflashes have important places in our research on hotflashes.
We recommend that investigators consider combining multiple methodologies to
obtain a more complete picture of hotflashes than any one measure can provide.
Rather than a source of concern, we view the discordance between measures as
informative. Examination of factors related to the degree of concordance or dis-
cordance between measures can be approached in substantive fashion to illuminate
factors that may influence the recall, reporting, and physiologic occurrence of hot
flashes. Great strides in the scientific measurement of hotflashes have been taken in
a relatively short period of time, yet further development is warranted. The valid
measurement of hotflashes is vitally important, as hotflashes are a significant
health issue impacting quality of life. Greater understanding of this common and
troubling phenomenon will pave the way for improving the quality of life for
millions of individuals around the world.
Acknowledgments This work was supported NIH grants R01HL105647 and K24123565
(Thurston) and T32HL083825 (Fisher/Orchard).
References
Anderson, G. S. (1999). Human morphology and temperature regulation.International Journal of
Biometeorology, 43(3), 99–109.
Armstrong, L. E., & Pandolf, K. B. (1988). Physical training, cardiorespiratory physicalfitness and
exercise-heat tolerance. In K. B. Pandolf, M. N. Sawka, & R. R. Gonzalez (Eds.),Human
performance physiology and environmental medicine at terrestrial extremes(pp. 199–226).
Indianapolis: Benchmark Press.
Avis, N. E., Colvin, A., Bromberger, J. T., Hess, R., Matthews, K. A., Ory, M., et al. (2009).
Change in health-related quality of life over the menopausal transition in a multiethnic cohort
of middle-aged women: Study of Women’s Health Across the Nation (SWAN).Menopause, 16
(5), 860–869.
Avis, N. E., Crawford, S. L., Bromberger, J., Everson-Rose, S. A., Greendale, G. A., & Gold, E. B.
(2013). Duration of vasomotor symptoms during the menopausal transition.Journal of
Women’s Health, 22(Published Abstract), 3.
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