Towards Anger Phenotyping of Indian Perimenopausal Females with Lyfas Anger Screening Optical Biomarker Instrument LASI

Background: Anger phenotyping in perimenopausal women is a complex task due to multifactor involvement. Anger sets sympathetic overdrive and affects the sympathovagal balance. Lyfas is a novel smartphone-based non-invasive optical biomarker instrument. It captures short Heart rate variability (HRV) and its correlated optical biomarkers using the method of arterial photoplethysmography and assesses the sympathovagal balance. Aims This study is designed to mine the significant optical biomarkers (SDNN, RMSSD, pNN50, SD1/SD2, and LF/HF) and physical parameters (Age, HR, BMI, systolic and diastolic BP, estradiol, TSH, HbA1c, and cortisol) to construct a novel hybrid L yfas A nger S creening I nstrument (LASI) and then validated against the well-acclaimed C linical A nger S cale (CAS) in anger phenotyping. Settings: and Design It is a case-control study with a total of 415 perimenopausal women (case: 205 and healthy control: 210). Methods and material: Lyfas tests were performed thrice/day for 2 weeks and their biomarkers’ scores are captured. During the same period, they have also recorded the anger episodes as per the CAS scoresheet. Statistical analysis used LASI is constructed using Spearman’s correlation (ρ and p-values) and validated against the CAS instrument with Bland Altman's inter-rater reliability assessment by noting the strength of agreement. Results BMI, BP, TSH, and HbA1c shows a significant positive correlation with anger. LASI scores high for recall (95%), specificity (75%), precision (92%), accuracy (71%), Youden’s index (J-statistic, 74%), and fscore (74%). Conclusion LASI is qualified to be used in the clinical setup in anger screening and monitoring.