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Oximeter failure to detect Hypoxia in darker skin

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Hazelpad View Drop Down
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    Posted: December 03 2021 at 7:08pm

As they measure light intensity through finger the pulse  oximeters may underestimate hypoxia in people with brown or black skin.  This could have huge consequences during the pandemic where accurate oxygen levels are essential.    In UK they say this may have led to avoidable covid deaths. The NHS guidelines have stated since 2020 that readings should be on trends  ( are they falling or rising) not on absolute numbers so to take this into account.  Just incase any one using at home please be aware of this.


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Black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry as White patients. Given the widespread use of pulse oximetry for medical decision making, these findings have some major implications

Bias in medical devices may have led to avoidable UK Covid deaths, says Javid | NHS | The Guardian

https://www.theguardian.com/society/2021/nov/21/sajid-javid-announces-review-racism-bias-medical-devices


https://www.nejm.org/doi/pdf/10.1056/NEJMc2029240?articleTools=true

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Post Options Post Options   Thanks (0) Thanks(0)   Quote A-I Quote  Post ReplyReply Direct Link To This Post Posted: December 03 2021 at 8:45pm

Javid made his comments as he announced the launch of a review into systemic racism and bias in medical devices

How is it that inanimate objects are actually racist and bias?  Wouldn't it rather be a design failure or engineering failure of those devices. Those medical devices don't know or care what color you are when they are used. They are incapable of feeling or believing so they can not be bias or racist as Merriam Webster defines bias as a tendency to believe that some people, ideas, etc., are better than others that usually results in treating some people unfairly

Now you would think that the designers/ manufacturers of the oximeters would have or should have ensured that it accurately measured oxygen levels of everyone regardless of skin tone. I would think that should it actually be found that they do not measure everyone's oxygen level accurately to a degree that it did indeed lead to or play a significant role in needless deaths then they have indeed incurred some rather severe liability as a result of that failure and rightly so.

But to use the terms systemic racism and bias in regards to oximeters is just hyperbole.

And in reading the NEJM article it's conclusions based on the testing are that inaccurate readings happen to whites as well, they just happen to blacks 3 times more. Clearly they need to design an oximeter that is accurate as inaccurate readings don't seem to be that uncommon.





"Facts don't care about your feelings" I'M A UNVAXXED DEVIL so kiss my rebel ass.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: December 04 2021 at 12:56pm

That's interesting. I agree with AI about the inaccurate use of the word racist. But I also read that many home oximeters are giving false readings. Over here, if you test Covid positive, the government sends you an oximeter to monitor your oxygen levels at home and a few of them have proved to be faulty, giving readings in the 90s even when the persons lips are turning blue. When the ambulance has got there, the true reading is much lower.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote ViQueen24 Quote  Post ReplyReply Direct Link To This Post Posted: December 04 2021 at 3:13pm

Yes, I agree the use of the word "racist" was unnecessarily inflammatory.  The use of the word "bias" could refer to 

a particular tendency, trend, inclination, feeling, or opinion, especially one that is preconceived or unreasoned:

illegal bias against older job applicants;

the magazine’s bias toward art rather than photography;

our strong bias in favor of the idea.  Dictionary.com

It's kind of like heart attacks.  For many years, doctors were ignorant of the fact that women have different symptoms than men when they have heart attacks, because heart attack studies had been performed primarily on men, so it was their symptoms and experiences they were expecting to see when looking to rule in or rule out heart attacks in both men and women.  Lots of women had undiagnosed heart attacks; some died, because of the unthinking bias of research.  Looking back, of course, it should've been known.  Apparently, no one thought of it.  Things are different now, as most medical professionals are aware that women are more prone to nausea, shortness of breath, lightheadedness, and irritability as the standard crushing chest pain that men more typically experience.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: December 05 2021 at 5:23pm

If fingers really cold them may not be accurate.   Also high temperature can cause vascular changes in periphery.  

Lots of inaccuracies in standards. One that gets me is the  old 1960 average  peadiateric heart rates used in NHS outdated as kids so unfit these days.

HZ 


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