WHEN PULSE OXIMETERS INTERFERENCE — Inaccuracies in pulse oximeter readings for people of color may have contributed to the toll of the pandemic, and proponents say the government is struggling to respond.
Studies have shown that pulse oximeters can often overestimate blood oxygen levels in dark-skinned people. Such inaccuracies led doctors to underestimate the severity of their disease and delay treatment, recent research showed:†
The devices, which are usually placed on a patient’s fingertip, use rays of light to estimate oxygen saturation levels. The Covid-19 pandemic brought pulse oximeters to more public attention as many people were using them at home.
The FDA warned doctors about the problem last year and is bringing experts together to discuss it later this year. An agency spokesperson said it has prioritized ensuring pulse oximeters are “adequately safe and accurate for all people,” but some public health advocates say the FDA is moving too slowly. A series of studies that found erroneous readings dates back decades, although many were small.
“It’s really shocking that it wasn’t until 2021 for the FDA to actually issue a warning,” said Uché Blackstock, an emergency medicine physician and CEO of Advancing Health Equity. “And even in that warning last year, they didn’t even mention racial prejudice or race or racism in it.”
In a December 2020 study, researchers at the University of Michigan found that black patients were about three times more likely than white patients to have low oxygen levels that go undetected. More than 1 in 10 black patients had dangerously low oxygen levels missing pulse oximeters.
Experts say the erroneous readings are due to the way light is absorbed differently by different skin tones.
The shortcomings increase concerns about technology bias as technology becomes ubiquitous in healthcare, as does the ability of regulators to stop it. Experts say racial inequality could worsen if technology doesn’t work the same for everyone, and warn that bias can creep into technology in a variety of ways.
“Prejudice can really occur anywhere in the chainfrom the laws of physics to sensors to data being stored to algorithms processing the data and eventually even people interpreting the algorithms,” said Achuta Kadambi, an engineering professor at UCLA. “Steps are certainly being taken. But there is still a long way to go.”
Solutions: Clinical trials have long underrepresented people of color. Experts say diversification is part of the solution.
It’s important for researchers to be intentional about increasing the diversity of trials, said Adrian Aguilera, the head of the Digital Health Equity and Access Lab at UC Berkeley, because they often don’t represent the wider population.
The FDA spokesperson said it wants to broaden the available evidence on the issue by funding a prospective clinical trial to change any recommendations.
But some proponents say the agency now knows enough about the flaws in the measurements to take more action.
Welcome back to Future Pulse, where we explore the convergence of healthcare and technology. You may not live forever, but it turns out your tattoos can† What other fascinating things dodge death these days? Tell us what you see.
Share your news, tips and feedback with Ben at [email protected] or Ruth on [email protected] and follow us on Twitter for the latest news @_BenLeonard_ and @RuthReader. Send tips securely via SecureDrop, Signal, Telegram or Whatsapp here†
Tony Romm @TonyRomm† “I just got a notification of covid exposure on my smartphone the week I had covid and was bedridden, in case anyone is curious about how this system works in the ommicron era.”
AFTER-ROE BIDEN ADMIN PRIVACY GUIDANCE — The Biden administration last week issued privacy guidelines for data covered by the landmark health privacy law HIPAA and the plethora of data that falls outside of it. Ben reports†
Guidance from HHS’ Office for Civil Rights intended to shed light on what data privacy rights individuals and healthcare organizations have in the new post-Roe v. Wade America.
The new legal landscape, with many states seeking to restrict abortion, has scared abortion advocates that prosecutors will use digital data, including health records, Internet search histories, and location data, to file charges against those terminating their pregnancies and/or the providers. he helped them.
The new guidelines have not created new rules — which would require a formal regulatory process — but clarified that abortion clinics cannot release abortion data to law enforcement without a court order. If a court issued an injunction, the clinics would be allowed, but not required, to hand over the files.
The administration’s guidelines for non-HIPAA data offered suggestions for protecting privacy online, including disabling location services, but emphasized that the tips would not protect all data.
GOOGLE MAKES DATA MOVE — Google said Friday it will remove location data from people who visit abortion clinics “shortly after” they travel to them. Olivia Olander of POLITICO reports.
The company and other major tech companies have come under fire from abortion rights advocates for their data practices, as prosecutors could potentially use the information to bring cases against abortionists or their suppliers.
Yes but: That still leaves a slew of data vulnerable, and the company’s policy change didn’t provide much clarity about how it would respond to law enforcement requests for data. The company only said it would “oppose claims that are too broad or otherwise legally objectionable”.
MEDICINE WASTE SEARCH SPIKE — Google searches for medication abortion have skyrocketed since POLITICO overturned the Supreme Court’s draft opinion Roe to Wade, according to a new study in JAMA Internal Medicine, Ruth reports†
In the three days after the news, searches for abortion drugs increased by 162 percent. In the week of the POLITICO report, Americans conducted 350,000 searches for abortion pills, the highest level recorded in a comparable time frame, the researchers said.
The states that saw the largest increase in drug abortion searches have some of the strictest restrictions on abortion.
Medication is already the most commonly used method before terminating a pregnancy, accounting for more than half of all abortions, according to the Guttmacher Institutea nonprofit reproductive health and policy organization that supports abortion rights.
BUILDING ON THE ELECTRONIC HEALTH REPORT — Shafiq Rab, chief digital officer at Tufts Medicine, tells POLITICO that building a technology platform in the cloud will help his health system use various data sources outside of the electronic health record to make predictions about patient health.
Rab says Tufts is trying to piece together information gathered from electronic health records, medical devices and other places where Tufts doctors monitor patients.
“What are the variables you need to understand sepsis? You want to understand age, date, gender, temperature, condition, diagnosis — all those things,” he says. “By creating that one ecosystem and that standard, we don’t depend on the EHR itself for our machine learning and for everything else. things, because all the data is in one place.”
TELEHEALTH’S ‘PARADOX’ — Telehealth has the potential to address health disparities between racial groups, Harvard researchers wrote in a commentary in Lancet Digital Health† But a lack of faith in technology could undermine its promise, they argue.
Vivian Yee, Simar Bajaj and Fatima Cody Stanford point to studies showing that black patients were more than four times more likely than white patients to go to the emergency room instead of using telemedicine. A patient’s satisfaction with virtual care was “mainly influenced” by how much they trusted their doctor, the researchers found.
“The lack of pre-established relationships with physicians, as well as distrust of digital platforms, could fuel this reluctance to pursue telemedicine,” they wrote.
PROMOTING GOOD HEALTH TO FIGHT CANCER — Pharmaceutical company Eli Lilly, in partnership with Sidekick Health, is launch an online platform for breast cancer patients in Germany. The app gives patients specific diet plans, physical activity regimens, and tools to stick to their medication, as well as suggestions for sleep and stress management. The aim is to see if behavioral changes in combination with medication can improve the results.
Meanwhile, Faeth, a startup developing new cancer drugs in tandem with meal plans designed to starve tumors, has raised $47 million to fund clinical trials.
A new dawn for psychedelics? — Helen Collis, POLITICS Europe
VC Deals and Valuations Begin to Fall Apart amid Biotech Stock Shock — Allison DeAngelis, STAT
Highway to health: unlocking full patient care through data interoperability — Julia Klein and Adriana Krasniansky, Rock Health