A long-documented, under-the-radar disparity is garnering new attention as the Covid-19 pandemic stretches into another year: Some pulse oximeters, which measure oxygen levels and are critical to making decisions about patient care, aren’t as accurate in Black patients and other people of color.
New research on the issue has drawn the attention of lawmakers and clinicians alike, who say they want to see the Food and Drug Administration launch sweeping studies to analyze how well pulse oximeters used in the hospital and at home work in a diverse pool of patients. Democratic Sens. Elizabeth Warren, Cory Booker, and Ron Wyden urged the agency late last month to review the devices, calling the issue “a matter of life or death” as the pandemic continues to take a disproportionate toll on communities of color.
“I hope for a pulse oximeter that I can use every day in the ICU that I don’t need to worry about if it doesn’t work as well for Black patients as for white patients,” said physician Thomas Valley, an author of a December study published in the New England Journal of Medicine that suggested that pulse oximeters produce misleading measurements in patients with darker skin. “And I hope for improved FDA regulations to prevent something like this from ever happening again.”
It is the responsible citizen who continues to care and to become aware of any disparities that may or may not occur in our Greater Dover Area and in the state of Delaware. Our health providing “Heroes” who are on the front line daily may wish to become the voice of any disparities that exist in our local health care facilities. Thank YOU to each and every Hero. “Trish”
The reading is always great but I don’t feel like it read i always thought to myself that it can’t be right most of the time I have shortness of breath but yet it read 98to a hundred my pulmonologist just change my inhaler to me neither one help me
Thank you both for this excellent examination of this issue. C. H.
the units themselves are not but the individuals who create them may be…learn to think outside of your bubble.
Must be due to the systemic racism of pulse oximeters.
I’ve been a nurse for 8 years with a degree in Biochemistry and I can tell you there is no difference in sp02 with vs without nail polish. So why would it matter your melanin if the article says this is a similar issue to that?
Also please do research on what products other countries are using and just compare those Two products. I think I answered this article’s question in two sentences
That’s incorrect. It depends on the chemistry of the nail polish. Anything that reflects or absorbs the specific frequencies of light used by a pulse oximeter will effect the readings. Some nail polishes won’t effect the readings, some will. Particularly those with metallic flakes. I’m a registered respiratory therapist.
“…..to depend on a device that may have bias toward a certain population is really troubling….”
So now even inanimate objects have biases. Are they racist too?
This is a burning issue that does need resolving.
However, in the middle of a 1-100 year pandemic in which citizens could benefit from using pulse oximeters at home to spot early signs of deterioration, getting admitted to hospital earlier and having a much shorter stay in hospital, we need to be careful about what messages we send to the wider population.
Headlines have been disseminated from this article that ‘Pulse Oximeters are racist’ which play into the current political conversation on both sides of the pond and can be seen as ‘common sense’. If the outcome from this is to deter non-white citizens from using these devices, what are the population-level outcomes likely to be?
Questions on my mind are:
1. Are these results obtained in a hospital setting and hospital devices transferable into community and citizen own use of FDA approved or CE marked consumer oximeters?
2. What is the nature of the error, is it a randomisation of the reading or a systemic shift up or down? If it’s the second, can we not adjust advice to BAME groups to work out ‘what’s normal for you’ and then advise clinicians who are tele-treating them a] of their skin colour b] of their normal range to aid remote treatment.
Ultimately I am concerned that we inadvertently end up with some kind of ‘health suppression’ effect for BAME citizens.
I’ve blogged more about the issue here: https://www.digitalhealthcoachuk.net/post/are-oximeters-safe-for-bipoc-bame-black-people-to-use-for-covid-yes-if-a-doctor-knows-your-colour