ArticleEClinicalMedicine2021
Performance of five pulse oximeters to detect hypoxaemia as an indicator of severe illness in children under five by frontline health workers in low resource settings - A prospective, multicentre, single-blinded, trial in Cambodia, Ethiopia, South Sudan, and Uganda.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 24 citations in OpenAlex.
- Predicting referral need for febrile children in low-resource community settings in South and Southeast Asia.Nature medicine · 2026Article
- Comparing pulse oximeter performance using a common functional tester versus controlled desaturation studies on healthy participants.Journal of clinical monitoring and computing · 2026Article
- Multimodal pulse oximeters to support the integrated management of childhood illnesses: A usability and diagnostic accuracy assessment from a multi-country hybrid type 2 study.PLOS global public health · 2026Article
- Review
- Article
- Article
- A pilot observational study of the association of 24-hour mortality with the subjective assessment of the forearm skin temperature and moisture compared to other bedside indicators of illness severity.Resuscitation plus · 2025Article
- Community health worker and caregiver experiences and perceptions of a multimodal handheld pulse oximeter used in sick child consultations in rural Burundi: A qualitative evaluation.PLOS global public health · 2025Article
- Implementation of a fast triage score for patients arriving to a low resource hospital in Uganda.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Predicting the potential impact of scaling up four pneumonia interventions on under-five pneumonia mortality: A prospective Lives Saved Tool (LiST) analysis for Bangladesh, Chad, and Ethiopia.Journal of global health · 2024Article
- Feasibility and acceptability of the paediatric pulse oximeter in integrated management of neonatal and childhood illnesses (IMNCI) services by public health facilities: A qualitative study in rural Western India.Journal of global health · 2023Article
- Risk and accuracy of outpatient-identified hypoxaemia for death among suspected child pneumonia cases in rural Bangladesh: a multifacility prospective cohort study.The Lancet. Respiratory medicine · 2023Article
- Defining the role of host biomarkers in the diagnosis and prognosis of the severity of childhood pneumonia: a prospective cohort study.Scientific reports · 2023Article
- A review of the effect of skin pigmentation on pulse oximeter accuracy.Physiological measurement · 2023Review
- Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda.PLOS global public health · 2023Article
- Development and an initial validation of the Responses to Illness Severity Quantification (RISQ) score for severely malnourished children.Acta paediatrica (Oslo, Norway : 1992) · 2022Article
- Cost-effectiveness and sustainability of improved hospital oxygen systems in Nigeria.BMJ global health · 2022Article
- Development of a repeated-measures predictive model and clinical risk score for mortality in ventilated COVID-19 patients.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Article
- Hypoxaemia prevalence and management among children and adults presenting to primary care facilities in Uganda: A prospective cohort study.PLOS global public health · 2022Article
- Paediatric pneumonia research priorities in the context of COVID-19: An eDelphi study.Journal of global health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 9 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow blood oxygen saturation (SpO
methodsFive pulse oximeters (POx) which passed laboratory testing, out of an initial 32 potential pulse oximeters, were evaluated by frontline health workers for performance, defined as agreement between the SpO
findingsTwo finger-tip pulse oximeters (Contec and Devon), two handheld pulse oximeters (Lifebox and Utech), and one phone pulse oximeter (Masimo) passed the laboratory testing. They were evaluated for performance on 1,313 children under five years old by 207 frontline health workers between February and May 2015. Phone and handheld pulse oximeters had greater overall agreement with the reference standard (56%; 95% CI 0.52 - 0.60 to 68%; 95% CI 0.65 - 0.71) than the finger-tip POx (31%; 95% CI 0.26 to 0.36 and 47%; 95% CI 0.42 to 0.52). Fingertip POx performance was substantially lower in the 0-2 month olds; having just 17% and 25% agreement. The finger-tip devices more often underreported SpO
interpretationWhile the Masimo phone pulse oximeter performed best, all handheld POx with age-specific probes performed well in the hands of frontline health workers, further highlighting their suitability as a screening tool of severe illness. The poor performance of the fingertip POx suggests they should not be used in children under five by frontline health workers. It is essential that POx are performance tested on children in routine settings (in vivo), not only in laboratories or controlled settings (in vitro), before being introduced at scale.
fundingBill & Melinda Gates Foundation [OPP1054367].
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.