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A flaw in one of medicine's most trusted devices - the pulse oximeter - was first documented in the 1990s, then largely forgotten. It took the COVID-19 pandemic to bring it back to the forefront.
Michael Sjoding, a pulmonologist and associate professor of medicine at the University of Michigan, was treating critically ill patients during the pandemic when he noticed something that didn't add up: pulse oximeter readings were overestimating blood oxygen levels compared with arterial blood gas tests. The discrepancy wasn't random. Black patients were significantly more likely to receive inaccurate readings than White patients.
In this episode, we talk about the impact of the study Dr. Sjoding and his colleagues published in the New England Journal of Medicine, what it reveals about the design of medical devices - and why he believes this is a problem that can be solved.
We discuss:
- Why pulse oximeters can produce less accurate readings in patients with darker skin - and what that means for clinical decision-making
- What the pulse oximeter problem reveals about inclusive design in medicine
- Why Dr. Sjoding believes his study gained traction where earlier research did not
About Michael Sjoding
Dr. Michael Sjoding is an Associate Professor in the Division of Pulmonary and Critical Care at the University of Michigan. His research focuses on developing new computational tools to support diagnosis and identify optimal treatment for patients with lung disease. He also studies how to effectively deploy these tools to support clinical decisions at the bedside.
Read the NEJM study on racial bias in pulse oximetry measurement: https://www.nejm.org/doi/10.1056/NEJMc2029240
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Other episodes you might like:
Signal in the noise: building bias-free medical devices
How to design a fairer healthcare system
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