Minority ethnic groups are getting less oxygen than white patients in intensive care units because of a flaw in a medical device found in hospitals around the world, a US study said on Monday.
The pulse oximeter, first developed in the 1970s, clips onto a patient’s finger and uses the absorption of red and infrared light to determine hemoglobin. However, it has been known to produce falsely elevated readings in people with darker skin.
In a new study published in JAMA Internal Medicine, Eric Raphael Gottlieb and colleagues looked back at records of 3,069 patients at Beth Israel Deaconess Medical Center in Boston who spent at least 12 hours in the hospital’s intensive care unit.
They compared the estimates of oxygen saturation on the pulse oximeters to more accurate direct readings of hemoglobin oxygen saturation.
After controlling for other variables, they found that Black, Asian, and Hispanic patients received 0.2 to 0.4 liters per minute less oxygen than their white counterparts.
“Our findings present a unique and compelling opportunity to improve equity by redesigning devices and re-evaluating how data is interpreted,” the team wrote.
Another recent study on the same topic showed that measurement bias in oxygen saturation was associated with a time lag in eligibility for treatment of Covid-19 for Black and Hispanic patients.
An accompanying editor’s note states that there are devices that perform more equitably but have never been widely adopted.
“Healthcare systems, including academic centers, are major buyers of pulse oximeters,” the editorial said. “If they committed to only buying devices that work across skin tones, manufacturers would respond.”
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