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Oxygen readers less accurate for nonwhite patients; likely delayed COVID treatments, study says

Study showed pulse oximeters overestimated blood oxygen levels in nonwhite patients

People using pulse oximeters, medical devices that measure the saturation of oxygen in red blood cells. (CNN)

A common device used to take the pulse and oxygen levels made nonwhite patients appear healthier than they were and may have delayed the need for COVID-19 treatment, according to a new study out of Johns Hopkins University.

Pulse oximeters are small devices that are clipped to a finger and used to measure a patient’s blood oxygen levels using light wavelengths. However, some studies have recently found accuracy issues in pulse oximeters because of skin pigmentation, according to the FDA.

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In the analysis conducted at Johns Hopkins and Baylor University, researchers compared the blood oxygen levels of over 1,200 patients with COVID using a pulse oximeter and arterial blood gas tests.

The researchers found that the pulse oximeters overestimated the blood oxygen levels in Black patients by 1.2%, 1.1% among Hispanic patients, and 1.7% among Asian patients.

That small percentage can be enough to decide not to use COVID-19 treatments more associated with severe cases because COVID affected oxygen levels in the blood.

The researchers then looked at another 6,600 COVID-19 cases and, through a statistical model, found that Black patients were 29% less likely than white patients to be eligible for treatment based on a pulse oximeter reading. Hispanic patients were 23% less likely.

Because pulse oximeters are less invasive than arterial blood gas tests, the researchers said the devices had become gatekeepers for COVID-19 treatment.

“We’ve shown that biases in pulse oximeter accuracy can mean the difference between receiving a necessary medication and not — and, critically, we were able to quantify how much this disproportionately affects minority communities,” said Dr. Tianshi David Wu, a study co-lead author.

The study was published in the Journal of the American Medical Association.


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