HealthDay News — Black patients have higher frequency of occult hypoxemia that is not detected by pulse oximetry, according to a research letter published in the New England Journal of Medicine.

Michael W. Sjoding, MD, from the University of Michigan Medical School in Ann Arbor, and colleagues examined potential racial bias in pulse oximetry measurements in a study involving adult inpatients receiving supplemental oxygen. A total of 10,789 pairs of measures of oxygen saturation by pulse oximetry and arterial oxygen saturation in arterial blood gas were analyzed from 1333 White patients and 276 Black patients in a University of Michigan cohort (January through July 2020), and 37,308 pairs were analyzed from 7342 White patients and 1050 Black patients in a multicenter cohort (2014 through 2015).

The researchers found that among patients with an oxygen saturation of 92% to 96% on pulse oximetry, an arterial oxygen saturation of less than 88% was found in 11.7% of Black patients and 3.6% of White patients in the University of Michigan cohort. The findings were similar in an adjusted analysis (11.4% and 3.6%, respectively). The area under the receiver operating characteristic curve for detecting an arterial blood gas oxygen saturation of less than 88% according to the oxygen saturation on pulse oximetry was 0.84 for Black patients and 0.89 for White patients in unadjusted analyses.

“Our findings highlight an ongoing need to understand and correct racial bias in pulse oximetry and other forms of medical technology,” the authors write.


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Several authors disclosed financial ties to the pharmaceutical and technology industries.

Abstract/Full Text