Study Finds Racial Bias In Faulty Oximeter Readings

The pulse oximeter is a frequently used device to measure oxygen saturation of the blood and the pulse rate. However, the pulse oximeter has been found to overestimate actual oxygenation.The inaccurate readings are typically found in patients identified as a racial and ethnic minority. A recent study published in the JAMA Network, has attempted to determine how inaccurate readings affect patient care. 

The study was conducted using a dataset of approximately 3,000 patients who were admitted to the ICU. The oxygenation levels and nasal cannula flow rates were examined for up to 5 days from the date of ICU admission. The patients analyzed consisted of various race and ethnicities. The researchers found that patients from Asian, Black and Hispanic backgrounds had received less supplemental oxygen. In addition, it was found that these patients had significantly greater differences between oxygen saturation determined by pulse oximetry and blood hemoglobin test.

The researchers contend that previous clinical research has demonstrated distinct racial and ethnic disparities in the temporally related pulse oximeter readings and blood hemoglobin oxygen saturation correlations, typically with higher pulse oximeter measurements in patients from racial and ethnic minority groups. Due to artificially inflated pulse oximeter readings in individuals with hidden hypoxemia, this raises the likelihood of this condition. Although it is not said  specifically if the differences in accuracy contributed to higher mortality in this study, the researchers stated that undetected hypoxemia is associated with higher death rates.  The researchers noted that inaccurate pulse oximeter readings can have dire consequences. The disparate results could affect decisions regarding fluid management, ICU admission, and specialty consultations. 

The researchers contend that their findings present a compelling opportunity for equity of care between races to improve through device reengineering. However, they encourage corrections to be made with caution, as previous attempts have shown to exacerbate disparity of treatment between race and ethnicities. The researchers believe that more research is needed to confirm the results found and to investigate additional clinical factors linked to treatment inequities.