ReviewAnnals of the American Thoracic Society2022
Racial Disparity in Oxygen Saturation Measurements by Pulse Oximetry: Evidence and Implications.
Review in Annals of the American Thoracic Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06491173 (Assessment of Accuracy, Precision, and Feasibility of a Handheld Near-Infrared Light Device), which is not on this map. Cited by 41 papers, 2 of them syntheses that pooled it.
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.
Assessment of Accuracy, Precision, and Feasibility of a Handheld Near-Infrared Light Device (InfraScanner 2500™) in Detecting Traumatic Intracranial Hemorrhage in Uganda
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Hypoxaemia and mortality in children with lower respiratory infection in low-income and middle-income countries: systematic review and meta-analysis.The Lancet. Global health · 2026Pooled it
- Singapore First Aid Guidelines 2026.Singapore medical journal · 2026Guideline
- Equity-Oriented Design Processes and Evaluation of Digital Health Technologies for Black Communities Beyond Usability: Scoping Review.Journal of medical Internet research · 2026Article
- Wearable Sensing for Clinical Physiology Monitoring: Emerging Paradigms.Physiology (Bethesda, Md.) · 2026Review
- Assessment of Noninvasive Measurement Techniques and Histologic Findings in a Mouse Model of LPS-Induced Acute Lung Injury.Journal of the American Association for Laboratory Animal Science : JAALAS · 2026Article
- Skin Tone in Hyperspectral Imaging and Its Implications for Fairness in AI.Journal of biophotonics · 2026Article
- Evaluation of SOFA-2 Score Performance Across Demographic Subgroups: An External Validation Study Using MIMIC-IV.medRxiv : the preprint server for health sciences · 2026Article
- Skin tone and clinical dataset from a prospective trial on acute care patients.Scientific data · 2026Article
- Quantifying the impact of hair and skin characteristics on fNIRS signal quality for enhanced inclusivity.Nature human behaviour · 2025Article
- Race Is an Incomplete Surrogate for Skin Pigmentation in Neonates, with Potential Relevance for Pulse Oximetry.The Journal of pediatrics · 2025Article
- Implementing AI models in clinical workflows: a roadmap.BMJ evidence-based medicine · 2025Article
- Perspective: Precision medicine in OSA: the future of a past and present riddle.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- The Epidemiology and Impact of Hypoxemia in Sub-Saharan Africa: Prevalence, Practices, and Outcomes.Annals of the American Thoracic Society · 2025Article
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- The Affordable Care Act's Call for Nondiscrimination: Addressing the Role of Pulse Oximetry in Racial Disparities.Annals of the American Thoracic Society · 2025Article
- Motion resistance in peripheral oxygen saturation monitoring using Biolight Analog SpOBMC anesthesiology · 2024Article
- Skin Phototype Classification with Machine Learning Based on Broadband Optical Measurements.Sensors (Basel, Switzerland) · 2024Article
- Quantifying the Impact of Hair and Skin Characteristics on Signal Quality with Practical Recommendations for Improvement.bioRxiv : the preprint server for biology · 2024Article
- Racial Biases Associated With Pulse Oximetry: Longitudinal Social Network Analysis of Social Media Advocacy Impact.Journal of medical Internet research · 2024Article
- Accuracy and Interpretation of Transcutaneous Carbon Dioxide Monitoring in Critically Ill Children.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024Observational
Corrections and comments
- Commented on by
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The pulse oximeter is a ubiquitous clinical tool used to estimate blood oxygen concentrations. However, decreased accuracy of pulse oximetry in patients with dark skin tones has been demonstrated since as early as 1985. Most commonly, pulse oximeters may overestimate the true oxygen saturation in individuals with dark skin tones, leading to higher rates of occult hypoxemia (i.e., clinically unrecognized low blood oxygen saturation). Overestimation of oxygen saturation in patients with dark skin tones has serious clinical implications, as these patients may receive insufficiently rigorous medical care when pulse oximeter measurements suggest that their oxygen saturation is higher than the true value. Recent studies have linked pulse oximeter inaccuracy to worse clinical outcomes, suggesting that pulse oximeter inaccuracy contributes to known racial health disparities. The magnitude of device inaccuracy varies by pulse oximeter manufacturer, sensor type, and arterial oxygen saturation. The underlying reasons for decreased pulse oximeter accuracy for individuals with dark skin tones may be related to failure to control for increased absorption of red light by melanin during device development and insufficient inclusion of individuals with dark skin tones during device calibration. Inadequate regulatory standards for device approval may also play a role in decreased accuracy. Awareness of potential pulse oximeter limitations is an important step for providers and may encourage the consideration of additional clinical information for management decisions. Ultimately, stricter regulatory requirements for oximeter approval and increased manufacturer transparency regarding device performance are required to mitigate this racial bias.
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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.