I think it varies from tank to tank. Some have indicator corals where they can look at the coral, and if there is a change in it's "behavior" or looks they know something is off, others can use PE, and I think Alk consumption is also a very good indicator of health. Generally I know something is off if polyp extension is reduced. Most of my Acros have very good PE during the daytime, and extreme PE at night. If I see a coral that normally has very good PE with little or no PE, I know to start checking things out. I recently had this happen, and after pulling my hair out trying to figure it out for about a week, I finally found the culprit. A magnet had rusted on my probe holder. Once I removed that, and did some large WC's, my tank found it's mojo again, and everything is happy. Every tank is different, and PE will not be an indicator in everyone's tank, but in mine, that is the case.