Faulty Oxygen Readings Delayed Covid Care for Black and Hispanic Patients: Study

Pulse oximeter readings are used routinely and help inform doctors in shaping medical care for any number of illnesses, including heart failure, sleep apnea and respiratory conditions. A normal reading for a patient in good health should be an oxygen saturation level in the blood of about 95 percent or higher. If the readings are falsely high, patients may look fine on paper — but they may not get the level of care they need.

The patients in the study released Thursday in JAMA Network Open were the ones researchers would have expected to have fared the best: Their doctors saw the need to take a more precise measure of their blood-oxygen levels. (Most patients’ fingertip reading is never double-checked with a blood draw.)

Patients with a fingertip pulse-oximeter reading of 94 percent or more but whose blood tests showed lower levels were deemed to have an unrecognized need for Covid therapy. Black patients were found to be nearly 50 percent more likely than white patients to have their condition go undetected. Hispanic patients were 18 percent more likely than white patients to have an unrecognized need.

Patients with unrecognized needs, regardless of race, experienced delays of roughly an hour that translated into a 10 percent higher risk of delayed Covid treatment. They were also more than twice as likely to be readmitted to the hospital.

The new study did not include patients whose oxygen levels might have mistakenly appeared normal via the pulse oximeter but had no follow-up blood test, and perhaps were sent home even though they may have been seriously ill.

“That’s the patient population that we’re really truly concerned about,” said Dr. Ashraf Fawzy, a study author who is a Johns Hopkins assistant professor and intensive care physician.

The Food and Drug Administration approves the type of fingertip pulse oximeter used in hospitals and sold by prescription. The agency issued a safety communication about the flaws in early 2021. And it held a hearing in the fall before an expert panel, with researchers outlining studies pointing to the role the device might have in deepening health disparities for patients with darker skin tone.

The agency approved those devices through its so-called 510(k) program, which clears devices that are similar to existing ones — with some additional scrutiny. The program has been criticized over the years because the standards for clearing devices are typically lower than those for the agency’s approval of new drugs.

During the hearing in November, the F.D.A. noted that the pulse oximeters sold over the counter are subject to even less oversight, prompting agency advisers to call for warnings to consumers who use the devices to gauge their own respiratory health.

The F.D.A. has not announced a major change in how it oversees pulse oximeters, but it said on Thursday that it planned to publish a discussion paper to get feedback on the issue and convene another meeting with experts to discuss potential approaches.

“It is a high priority for the agency to ensure that oximetry device performance is equitable and accurate for all U.S. patients,” the agency said in a statement.

Some work has also begun to design a better pulse oximeter.

For now, though, Dr. Fawzy said doctors should trust their overall impression of a patient’s condition when taking a pulse-oximeter reading into account.

“It’s important for us to recognize that this device may lead to clinical decisions that are inaccurate,” he said, “or that we may be under-treating certain people or under-recognizing their needs.”


Source link

Related Posts

U.S. Leading Soft Landing for Global Economy

The world is starting 2024 on an optimistic economic note, as inflation fades globally and growth remains more resilient than many forecasters had expected. Yet one country…

Job Market Starts 2024 With a Bang

The United States produced an unexpectedly sizable batch of jobs last month, a boon for American workers that shows the labor market retains remarkable strength after three…

6 Reasons That It’s Hard to Get Your Wegovy and Other Weight-Loss Prescriptions

About 3.8 million people in the United States — four times the number two years ago — are now taking the most popular weight-loss drugs, according to…

Sean Wang Lives His ‘Fairy Tale’ at Sundance

“I feel like I’m in a fairy tale,” Sean Wang said to the sold-out crowd gathered at the Ray Theater in Park City, Utah, last month for…

Meta’s Stock Surges After Jump in Profits

Meta’s stock price soared on Friday, adding hundreds of billions of dollars to the market value of the social media giant that owns Facebook, Instagram and WhatsApp….

He’s Lost His Marriage, His Followers and His Lamborghini

With its streamlined curves and glow-in-the-dark sound system, the silver Lamborghini Huracán Performante was the stuff of teenage fantasy: $350,000 of aerodynamic metals and lightweight upholstery, packed…

Leave a Reply

Your email address will not be published. Required fields are marked *