EquiOx: a prospective study of pulse oximeter bias and skin pigmentation in critically ill adults with stable oxygenation.

Diagnostic technologies can perpetuate inequities when precision varies across patients. In this prospective single-center study of 631 critically ill adults, researchers compared pulse oximeter readings with arterial oxygen saturation using subjective and objective skin-pigmentation measures. The results show that FDA-cleared pulse oximeters tested systematically underestimated arterial oxygen saturation, with less bias in patients with darker skin - in contrast to earlier studies which found that pulse oximetry was less accurate in patients with darker skin. The findings suggest ICU pulse oximeter inaccuracies may overall be more widespread than recognized and continue to warrant attention as a diagnostic equity issue.