4/30/2024 0 Comments Actor and observer bias![]() ![]() Prof Habib Naqvi, the chief executive of the NHS Race and Health Observatory, welcomed the findings, adding the review acknowledged the need for immediate modifications, equity assessments and tighter guidance and regulation around pulse oximeters and other medical devices. Among examples highlighted by the report are race-based corrections applied to measurements from devices known as spirometers that are used to assess lung function and diagnose respiratory conditions, have themselves been found to contain biases. However, attempts to correct biases can also be problematic. “Major genetic datasets that polygenic risk scores use are overwhelmingly on people of European ancestry, which means that they may not be applicable to people of other ancestries,” said Enitan Carrol, professor of paediatric infection at the University of Liverpool and a co-author of the review. The report also noted problems with polygenic risk scores – which are often used to provide a measure of an individual’s disease risk due to their genes. Concerns over the latter, they say, is down to the fact AI devices are largely trained on images of lighter skin tones. Instead the review puts forward a number of measures to improve the use of pulse oximeters in people of different skin tones, including the need to look at changes in readings rather than single readings, while it also provides advice on how to develop and test new devices to ensure they work well for patients of all ethnicities.Ĭoncerns over AI-based devices were also highlighted by the report, including the potential for such technology to exacerbate the under-diagnosis of cardiac conditions in women, lead to discrimination based on patients’ socioeconomic status, and result in under-diagnosis of skin cancers in people with darker skin tones. The team members stress they are not calling for the devices to be avoided. The report has confirmed concerns pulse oximeters overestimate the amount of oxygen in the blood of people with dark skin, noting that while there was no evidence of this affecting care in the NHS, harm has been found in the US with such biases leading to delayed diagnosis and treatment, as well as worse organ function and death, in Black patients. ![]() The widely used devices were thrown into the spotlight due to their importance in healthcare during the Covid pandemic, where low oxygen levels were an important sign of serious illness.
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