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Study: Pulse oximeters systematically overestimated oxygen levels for Black people during pandemic

"The pulse oximeter may have contributed to the disparities and outcomes - mainly the thousands of deaths of people of color from this novel disease."

CALIFORNIA, USA — A  new Sutter Health study released Thursday morning details disparities in the treatment people of color received for COVID-19 and revealed a delay in a commonly used medical device.

The study found pulse oximeters, or the device placed on a patient's finger to read blood oxygen levels through the skin, could have given false readings because of a person's pigment.

It happened as the Black community became one of the most at-risk during the peak of the COVID-19 pandemic.

"Our community was a lot more vulnerable when it came to COVID. Factor that in along with the lack of access to the vaccine. Especially early on, it exacerbated the situation," said Rhonda Smith, who is the executive director, of the California Black Health Network

This is on top of the new study from Sutter Health linking bias in medical technology to clinical COVID care.

"The study confirmed that pulse oximeters systematically overestimate oxygen levels for black individuals due to the device's inability to accurately read oxygen levels on darker-skinned individuals," said Kristen Azar, who is the scientific medical director for Sutter Health Institute for Advancing Health Equity. 

Doctors say it was the deciding factor between mild and severe disease since the guidelines for treatment are dependent on the readings from these devices.

"This tool, the pulse oximeter, may have contributed to the disparities and outcomes… mainly the thousands of deaths of people of color from this novel disease," said Stephanie Brown, who is an emergency medicine doctor with Sutter Health. 

Azar said it was because existing treatment guidelines, which use the pulse oximeter as a key trigger, were associated with a roughly 5-hour delay in COVID-19 treatment for Black patients along with delays in time to supplemental oxygen. 

"Because of existing treatment guidelines, which use the pulse ox level as a key trigger, for clinical action was associated with around a 5-hour delay in COVID-19 treatment for Black patients. As well as delays in time to supplemental oxygen. Dexamethasone treatment" added Azar. 

There was also a greater chance patients would be sent home from the emergency department.

Sutter Health says the research is just one component of its comprehensive approach to uncovering bias within medicine.

"This clearly needs to be corrected immediately, both by the regulatory bodies and the manufacturers. And healthcare providers are going to need to replace these devices with accurate devices," said Dr. Noha Aboelata, with Sutter Health. 

The California Black Health Network agrees.

"From a policy perspective, we're trying to do our part to prioritize addressing these issues at the system level of healthcare," Smith said. 

To further their efforts, Sutter Health and other partners plan on hosting a symposium around unconscious bias and healthcare, which is happening next month. 


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