Racial Bias in Pulse Oximetry Measurement

Overview

Oxygen is among the most frequently administered medical therapies, with a level that is commonly adjusted according to the reading on a pulse oximeter that measures patients’ oxygen saturation. Questions about pulse oximeter technology have been raised, given its original development in populations that were not racially diverse. The clinical significance of potential racial bias in pulse oximetry measurement is unknown.

Our study involved adult inpatients who were receiving supplemental oxygen at the University of Michigan Hospital (from January through July 2020) and patients in intensive care units at 178 hospitals (from 2014 through 2015). We analyzed paired pulse oximetry measures of oxygen saturation and measures of arterial oxygen saturation in arterial blood gas, with all evaluations performed within 10 minutes of each other. To ensure that the arterial oxygen saturation was directly measured by co-oximetry, we limited analyses to measures of arterial blood gas that included carboxyhemoglobin and methemoglobin saturations.

Principal Investigator(s)

Michael W. Sjoding, M.D.

Robert P. Dickson, M.D.

Theodore J. Iwashyna, M.D., Ph.D.

Steven E. Gay, M.D.

Thomas S. Valley, M.D.

Digital Health Innovation Support

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