Effect of skin tone on the accuracy of the estimation of arterial oxygen saturation by pulse oximetry: a systematic review
Authors' conclusion
Pulse oximetry can overestimate true SaO2 in people with darker skin tones. The clinical relevance of this bias remains unclear, but its magnitude is likely to be greater when SaO2 is lower.
Study context
- Population
- Adults and children in clinical and non-clinical studies with SpO2 compared with paired co-oximetry saturation (SaO2)
- Participants
- 222,644 adults · 44 studies
- Comparison
- SpO2 vs paired co-oximetry SaO2 by skin tone
- Outcome
- Effect of skin tone on accuracy of pulse oximetry estimation of SaO2
Methodological detailsQUADAS-2 risk of bias, GRADE certainty assessment, no meta-analysis, Literature searched from inception to March 20, 2023
- QUADAS-2 risk of bias
- GRADE certainty assessment
- No meta-analysis
- Literature searched from inception to March 20, 2023
Pooled result
As reported in the abstract
Accuracy of SpO2 vs SaO2 by skin tone
- Majority of studies reported overestimation of SaO2 by pulse oximetry in participants with darker skin tones or from ethnicities assumed to have darker skin tones
- Several studies reported no inaccuracy related to skin tone
- Meta-analysis not possible
Further pooled results
Study characteristics
- Paired SpO2-SaO2 measurements
- 733 722
- Children
- 6121
- Studies with high risk of bias (RoB)
- 64%
- Studies measuring skin tone
- 11 (25%)
- Participants with measured skin tone
- 2353 (1.1%)
- Participants of non-White ethnicity or non-light skin tones
- 68 930 (31.0%)
- Considerable heterogeneity in study design, data analysis, and reporting metrics
Original publication
Effect of skin tone on the accuracy of the estimation of arterial oxygen saturation by pulse oximetry: a systematic review. Br J Anaesth. Published 17 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →