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Pulse oximeters give biased results for people with darker skin

bostonreview.net

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Re: Pulse oximeters give biased results for people with darker skin

#121

Earlier quoted context omitted.

Both measurement and social/cultural bias occur in physics: https://scholar.google.com/scholar?q="bias%20in%20physics"&b... "Cargo Cult Science" (esp. Millikan). http://calteches.library.caltech.edu/51/2/CargoCult.htm Einstein to M. Curie: https://www.brainpickings.org/2016/04/19/einstein-curie-lett... Planck: Science advances one funeral at a time. (See also Kuhn.) https://en.wikiquote.org/wiki/Max_Planck

Yes, and the point that I'm making is that "this isn't bias, this is physics" is missing the point. Yes, the way in which varying wavelengths of light interact with varying configurations of bulk matter is a physical phenomenon, and not subject to bias. But that isn't the same as saying, as the comment to which I originally replied seemed to do, that no bias can exist in the way in which that phenomenon is interprete…

I suspect instances of bias introduced by other-than cultural, social, human, and perceptual dynamics are also present.

Re: Pulse oximeters give biased results for people with darker skin

#122

IIUC, dark-skinned people have higher covid19 mortality rates, and physicians usually(?) use this kind of oxymeter in their decision-making. I wonder if there's a connection.

Here's a good article that discusses why Black Americans have higher mortality rates:

"systemic racism is as much a part of biology as genomes are: The conditions in which we develop—including limited access to healthy food, exposure to toxic pollutants, the threat of police violence or the injurious stress of racial discrimination—influence the likelihood that any one of us will suffer from high blood pressure, diabetes or serious complications from COVID-19"

https://blogs.scientificamerican.com/voices/racism-not-genet...

Re: Pulse oximeters give biased results for people with darker skin

#123
post #100

Earlier quoted context omitted.

This IS NOT BIAS ! This is physics! As someone else pointed out, this isn't only about melanin in the skin. Darkened skin for any reason will cause this (burns, smoking, dirt, etc...). Medical personnel are trained to account for this partial accuracy. The other fact is that there are newer techniques being worked on to improve the technology.

> This IS NOT BIAS ! This is physics! You sound pretty emotional, maybe tone it down and try to think objectively. Just because there's an underlying physical reason for the device to be inaccurate on a subset of the population, doesn't mean that it's fair to use that device on the impacted population. It's been accepted by the medical community, despite the additional training required to correctly use the device --…

[deleted]

Re: Pulse oximeters give biased results for people with darker skin

#124
post #25

Earlier quoted context omitted.

The article notes that the devices inaccurately report higher oxygen levels for darker skin tones. Meaning if someone dark skinned reports a result that falls into the 94-100% range, they may in fact be at lower oxygen levels that put them at risk.

That's true. There are other context clues that we can use, like a patient's medical history, how their breathing looks/sounds, or if their environment or mental status suggests CO poisoning (that also won't show up even on the perfect pulse ox, since it binds to hemoglobin the same way oxygen does). Overall we just need a better way to get information about oxygen levels.

At first thought, a hemoglobin protein loaded up with CO molecules should have slightly less mass than an oxygenated hemoglobin complex, which could... theoretically... be measured, maybe with Raman spectroscopy.

That effect is going to be tiny, though. Wikipedia is telling me a hemoglobin tetramer masses "about" 64,000 daltons, so a complex loaded up with 4CO will mass 64,111 vs 64,127 amu. 0.024% difference.

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