The inaccurate measurements contributed to nearly five-hour delays in COVID-19 treatment, which was critical time for the potentially fatal virus, according to the study.
“The findings underscore the fact that bias is not only human, it can be ingrained in the devices and tools clinicians rely on, too,” said Dr. Stephanie Brown of Sutter Health’s Institute for Advancing Health Equity. “To build a more equitable healthcare system we must continue to not only uncover where bias exists in medicine, but also work to understand its impact on clinical outcomes and how it can be corrected.
The Food and Drug Administration in 2021 issued special guidance on pulse oximiters because of their heavy use during the pandemic. It noted their accuracy depended on many factors, such as circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish.
As a result, “it was harder for clinicians to appropriately treat their Black patients suffering from COVID-19 which resulted in measurable treatment delays and contributed to structural racism in health care, regardless of clinician intent,” Azar said. Dr. Noha Aboelata, CEO of the Roots Community Health Center in Oakland, California, called the study “disturbing” given that pulse oximeters or so commonly used in health care and that they were know to be less accurate for people with darker skin tones.