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There’s a growing consensus among physicians and government regulators that pulse oximeters measure oxygen levels less accurately in patients with darker skin and need to be fixed.

There’s another problem, however, that needs to be fixed first. Much of the work and research to understand the devices’ shortcomings and devise solutions is focused on race. But the issue with pulse oximeters is not one of race — it’s very clearly one of skin tone. The light used in the devices to detect oxygenated blood can be blocked by melanin in the skin.

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