The device did record activity akin to a hot flash. Otte et al(9) state that hot flashes can be differentiated from exercise-induced sweating, but this article nor the one referenced to support this
statement (12) provides any data to definitively prove this. The ability to pick up skin conductance from various sweating etiologies may explain why hot flash physiologic monitors pick up more ‘‘hot flashes’’ than do participant diaries. Next,
these physiologic measures of hot flashes can be cumbersome, expensive, and not well tolerated by participants. This is particularly true if they are used to measure hot flashes over several days to weeks, as opposed to on a single day.
There is no substantial information to judge whether hot flash changes over time (from a baseline week to different times after treatment has been initiated) are better measured using sternal skin conductance monitors versus hot flash diaries.
Such information should become available before widespread use of these devices, in lieu of participant diaries. We suspect, in the end, that both participant diaries and physiologic measures will provide complimentary information.
Thus, in total, we agree with Otte et al (9) when they state ‘‘that the perception of a hot flash is just as important to investigate in the absence of an objective marker of that hot flash.’’
At the current time, participant reported outcome measures of hot flashes should be considered to be the criterion standard because they, currently, are in other symptom control trials, looking at things such as pain, nausea and vomiting, and treatment-induced peripheral neuropathy.(14)
Acupuncture as a Hot Flash Treatment
With regard to hot flash treatments, there is a study in this issue by Park et al (15) about the use of moxibustion, a specialized form of acupuncture, to alleviate hot flashes. It is difficult to evaluate the contribution of this exploratory pilot study for a couple of reasons. There was no attempt to use an adequate control arm, understanding the difficulties related to devising a placebo for the studied procedure. It should also be noted that a placebo effect of 50% is not unusual.