Critical Bias in Critical Care Devices
Abstract
Critical care data contain information about the most physiologically fragile patients in the hospital, who require a significant level of monitoring. However, medical devices used for patient monitoring suffer from measurement biases that have been largely underreported. This article explores sources of bias in commonly used clinical devices, including pulse oximeters, thermometers, and sphygmomanometers. Further, it provides a framework for mitigating these biases and key principles to achieve more equitable health care delivery.
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Measurements of the pulse oximeter are known to be affected by the patient's skin color, leading the device to systematically overestimate oxygen saturation levels in non-White patients.
“Measurements of the pulse oximeter are known to be affected by the patient’s skin color, which leads to the device systematically overestimating oxygen saturation levels in non-White patients [30].”
From Bias in artificial intelligence algorithms and recommendations for mitigation (2023) · cites this paper as [30]
Certain measurements derived from commonly used medical devices, such as pulse oximeters, thermometers, and sphygmomanometers, may be sources of bias among patient subpopulations.
“Certain measurements derived from commonly used medical devices may also be sources of bias among patient subpopulations, such as pulse oximeters, thermometers, and sphygmomanometers [30].”
From Bias in artificial intelligence algorithms and recommendations for mitigation (2023) · cites this paper as [30]
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Bias in artificial intelligence algorithms and recommendations for mitigation
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- Authors
- Charpignon, M.-L., Byers, J., Cabral, S., Celi, L. A., Fernandes, C., Gallifant, J., Lough, M. E., Mlombwa, D., Moukheiber, L., Ong, B. A., Panitchote, A., William, W., Wong, A.-K. I., & Nazer, L.
- Affiliations
- Massachusetts Institute of Technology (US)
- Beth Israel Deaconess Medical Center (US)
- St Thomas' Hospital (GB)
- Stanford Health Care (US)
- Kamuzu University of Health Sciences (MW)
- University of the Philippines Manila (PH)
- Khon Kaen University (TH)
- Duke Medical Center (US)
- King Hussein Cancer Center (JO)
- Corresponding author
- Charpignon, Marie-Laure
- ORCID
- Venue
- Critical Care Clinics
- Publisher
- Elsevier BV
- Published
- 2023-10
- Volume
- 39
- Issue
- 4
- Pages
- 795-813
- ISSN
- 0749-0704 (ISSN-L)
- OpenAlex
- W4361004018
- Cited by
- 35
- References
- 17
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 10 · 2023: 4
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Critical Care Clinics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- measurement bias, intensive care monitoring, pulse oximetry, thermometers, sphygmomanometer, patient monitoring systems, bias mitigation, health equity, critically ill patients
- MeSH terms
- Critical Care, Humans, Bias
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