ArticleQJM : monthly journal of the Association of Physicians2023
Differential pulse oximetry readings between ethnic groups and delayed transfer to intensive care units.
Article in QJM : monthly journal of the Association of Physicians, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Do Differences in Skin Pigmentation Affect Detection of Hypoxemia by Pulse Oximetry: A Systematic Review of the Literature.Clinical nursing research · 2025Pooled it
- Evaluation of skin pigmentation effect on photoplethysmography signals using a vascular finger phantom with tunable optical and mechanical properties.Journal of biomedical optics · 2025Article
- Reducing inequalities through greater diversity in clinical trials - As important for medical devices as for drugs and therapeutics.Contemporary clinical trials communications · 2025Article
- A requirement for the use of supplementary oxygen to guide medical treatment decisions may introduce bias against non-white individuals.The European respiratory journal · 2024Article
- Exploring the bias: how skin color influences oxygen saturation readings via Monte Carlo simulations.Journal of biomedical optics · 2024Article
- Discrepancy between arterial oxygen saturation and pulse oximetry measurement in a Chinese pediatric patient cohort.Heliyon · 2024Article
- Racial effects on masimo pulse oximetry: impact of low perfusion index.Journal of clinical monitoring and computing · 2024Article
- Approaches to developing de novo cancer population models to examine questions about cancer and race in bladder, gastric, and endometrial cancer and multiple myeloma: the Cancer Intervention and Surveillance Modeling Network incubator program.Journal of the National Cancer Institute. Monographs · 2023Article
- Validation of a Smart Ring Oximeter in Individuals With Dark Skin Pigment.Mayo Clinic proceedings. Digital health · 2023Article
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPulse oximeters are widely used to monitor blood oxygen saturations, although concerns exist that they are less accurate in individuals with pigmented skin.
aimsThis study aimed to determine if patients with pigmented skin were more severely unwell at the period of transfer to intensive care units (ICUs) than individuals with White skin.
methodsUsing data from a large teaching hospital, measures of clinical severity at the time of transfer of patients with COVID-19 infection to ICUs were assessed, and how this varied by ethnic group.
resultsData were available on 748 adults. Median pulse oximetry demonstrated similar oxygen saturations at the time of transfer to ICUs (Kruskal-Wallis test, P = 0.51), although median oxygen saturation measurements from arterial blood gases at this time demonstrated lower oxygen saturations in patients classified as Indian/Pakistani ethnicity (91.6%) and Black/Mixed ethnicity (93.0%), compared to those classified as a White ethnicity (94.4%, Kruskal-Wallis test, P = 0.005). There were significant differences in mean respiratory rates in these patients (P < 0.0001), ranging from 26 breaths/min in individuals with White ethnicity to 30 breaths/min for those classified as Indian/Pakistani ethnicity and 31 for those who were classified as Black/Mixed ethnicity.
conclusionsThese data are consistent with the hypothesis that differential measurement error for pulse oximeter readings negatively impact on the escalation of clinical care in individuals from other than White ethnic groups. This has implications for healthcare in Africa and South-East Asia and may contribute to differences in health outcomes across ethnic groups globally.
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