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Breaking barriers: Tackling bias in medical tech with Pulse Oximeters.

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TLDR:

  • Systemic racial bias in healthcare technologies can lead to inaccurate readings and delayed care for patients with darker skin pigmentation.
  • Pulse oximeters, which measure oxygen levels in the blood, have been found to provide inaccurate readings in individuals with dark skin.
  • The FDA advisory panel has reviewed ways to improve the accuracy of pulse oximeters, including new clinical trial requirements and using specific measurement scales and angles.
  • A recent study by medical technology company Masimo found that their pulse oximetry accurately measures oxygen levels in both Black and White individuals, offering hope for more equitable healthcare technologies.

Healthcare technologies have been found to have systemic racial bias, leading to potential inaccuracies and delayed care for patients with darker skin pigmentation. One specific technology that has come under scrutiny is the pulse oximeter, a device used to measure oxygen levels in the blood. In a Canadian Medical Association Journal article, a Black physician-patient shared their experience with using a pulse oximeter and how it proved unreliable due to their darker skin pigmentation. This highlights the intersection of medical, Black, and patient identities, and exposes the systemic racial bias in health technology design.

The unreliability of pulse oximeters for individuals with dark skin can have life-threatening implications, particularly for Black patients with COVID-19. This racial bias not only limits the effectiveness of these tools but also undermines trust in healthcare among Black communities. It is crucial to address these issues and work towards more accurate devices and greater equity in health curricula and clinical practice.

In response to the issue of inaccurate readings from pulse oximeters in individuals with darker skin, the FDA advisory panel has recommended new clinical trial requirements to ensure the devices are accurate across all skin tones. They have also discussed using the Monk Skin Tone (MST) scale and Individual Typology Angle (ITA) for measurements. Additionally, the panel has considered placing over-the-counter pulse oximeters behind the pharmacy counter to ensure proper understanding of their use.

Despite the challenges, there have been promising developments in pulse oximetry technology. A recent study by medical technology company Masimo found that their pulse oximetry measures accurately on both Black and White individuals, even during low perfusion. This study analyzed data from self-identified Black and White volunteer subjects and found no significant difference in accuracy or bias based on skin tone. This advancement offers hope for more equitable healthcare technologies in the future.

Systemic racial bias in health technology design is a deeply entrenched issue that requires ongoing attention, innovation, and commitment to resolve. The experience of the Black physician-patient and the FDA advisory panel discussions highlight the urgent need for healthcare technologies that consistently deliver equity and accuracy. By addressing these biases and inequities, the goal of a healthcare system that serves everyone, regardless of their race or skin color, can be achieved.

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