Podcast Summary
Pulse oximeters misreading oxygen levels for patients with darker skin tones: During the pandemic, pulse oximeters inaccurately measured oxygen saturation for people with darker skin, emphasizing the need for diverse perspectives and open communication in healthcare.
During the height of the COVID-19 pandemic in 2020, pulse oximeters, devices used to monitor blood oxygen saturation levels, were found to misread oxygen levels in patients with darker skin tones. This issue, which had been previously documented but not widely recognized, gained significant attention when a study was published in the New England Journal of Medicine. The controversy surrounding the accuracy of the devices led to a series of investigative reports confirming the issue. Despite being an engineer and being familiar with the technology, Khemani Toussaint, a professor at Brown University, was not aware of the problem until his wife, an epidemiologist, brought it to his attention. The device manufacturer initially denied the issue, but the evidence continued to mount. This incident highlights the importance of diverse perspectives and open communication in addressing critical health issues.
Pulse oximeters inaccurately read oxygen levels for individuals with darker skin tones: Doctors advocate for next-gen pulse oximeters to address inaccuracies for darker skin tones, affecting millions, and FDA recognizes the issue. Remember, arterial blood gas tests are the gold standard for measuring oxygen levels.
There is a significant issue with pulse oximeters providing inaccurate readings for individuals with darker skin tones, leading to potential delays or denial of COVID-19 treatment. This problem has been known for decades but lacked attention due to underrepresentation in larger journals and textbooks. Doctors like Noha Abolata are now advocating for the development of next-generation pulse oximeters that are accurate for all skin tones. This issue, which could potentially affect millions of Americans, has gained recognition from the FDA. It's important to remember that pulse oximeters are not the only method for measuring blood oxygen levels, as the gold standard is an arterial blood gas test. This discrepancy highlights the importance of addressing health disparities and ensuring that all individuals receive accurate and equitable healthcare.
Measuring Oxygen Levels with Pulse Oximeters: Pulse oximeters provide non-invasive, instant oxygen saturation readings, but levels below 89% may indicate a need for supplemental oxygen. They should be used as a guide rather than the sole determinant of care.
Pulse oximeters have become essential tools in modern medicine due to their non-invasive nature and ability to provide instant oxygen saturation readings. These devices measure the amount of oxygen-rich (oxyhemoglobin) and oxygen-poor (deoxyhemoglobin) blood in the body by analyzing light absorption through the skin. A reading between 95% and 100% is considered healthy, but levels below 89% can indicate a need for supplemental oxygen. However, it's important to note that pulse oximeters are not infallible, and their readings should be used as a guide rather than the sole determinant of a patient's care.
Accuracy issues with pulse oximeters for individuals with darker skin tones: Historical underrepresentation of diverse populations in pulse oximeter development and testing led to inaccuracies and potential health inequities.
The use of pulse oximeters, devices essential for measuring oxygen saturation levels in patients, has been found to have accuracy issues when used on individuals with darker skin tones due to the presence of melanin. This issue, rooted in historical underrepresentation of diverse populations in the development and testing of these devices, can lead to health inequities and potentially inaccurate diagnoses. An example of a more equitable solution is the Hewlett Packard oximeter from the 1970s, which used 8 wavelengths and was tested on both black and white patients, allowing for accurate calibration for different skin tones. The lack of diversity in clinical trials and testing during the 1980s, combined with the shift in focus from medical devices to computers by HP, led to the widespread use of less accurate devices. This underscores the importance of inclusivity and representation in the development and testing of medical technology to ensure equitable healthcare for all.
Pulse oximeter readings overestimate oxygenation in non-White patients: During the pandemic, pulse oximeter readings inaccurately overestimated oxygenation levels in Black, African American, and other non-White patients due to melanin, potentially leading to delayed or inappropriate care and serious consequences.
During the pandemic, pulse oximeter readings, which were used as cutoffs in emergency rooms to determine if patients needed further care, were found to systematically overestimate blood oxygenation in Black, African American, and other non-White patients due to melanin. This led to some individuals not receiving timely or appropriate care, potentially resulting in serious consequences, including death from COVID-19. Noha Abolata, CEO of the Roots Community Health Center in Oakland, shared her experience of encountering such discrepancies in readings and the frustration of not being able to secure necessary oxygen therapy for her patients due to inaccurate pulse oximeter readings. While workarounds, such as watching for large swings in readings and not relying solely on the numbers, have been implemented, a more advanced and accurate device is under development at Brown University by Kimani Toussaint and his doctoral student, Rutendo Jakashira. Their prototype utilizes the polarization or electric field properties of light to improve pulse oximetry technology. This discovery underscores the importance of addressing health disparities and ensuring equitable access to accurate and effective medical technology.
Developing an Accurate Oximeter for Darker Skin Tones: Researcher Dr. Kimani is creating a new oximeter with unique polarization properties to measure oxygen levels accurately in individuals with darker skin tones, addressing current inaccuracies in pulse oximeters and promoting health equity.
Dr. Kimani, a researcher at Brown University, is working on developing a new type of oximeter that uses a single light source with unique polarization properties to measure oxygen levels in the blood more accurately, regardless of melanin. This innovation could address the inaccuracies in current pulse oximeters for individuals with darker skin tones. The prototype, which is larger and more customizable than traditional models, is being tested at Merriam Hospital in Rhode Island. The potential impact of this work is significant, as Dr. Kimani has received numerous emails from people across the country expressing interest and hope for a solution to this issue. This project goes beyond improving pulse oximetry; it represents a crucial step towards health equity and fairer access to medical technology.
