Respiratory failure & ventilation
The impact of skin tone on performance of pulse oximeters used by NHS England COVID Oximetry @home scheme: measurement and diagnostic accuracy study
Authors' conclusion
Five pulse oximeters provided by the NHS England COVID Oximetry @home scheme yielded higher SpO2 measurements for patients with darker skin tones compared with those with lighter skin tones, which could translate into potentially clinically important differences in false negative and false positive rates for detecting hypoxaemia.
Study context
- Population
- Critically ill adults in 24 English ICUs screened for or enrolled into an oxygen therapy trial, June 2022–August 202411,018 paired measurements
- Participants
- 903 adults
- Comparison
- Darker skin tone vs Lighter skin tone
- Outcome
- Measurement accuracy (bias, precision, overall accuracy) and diagnostic accuracy for SaO2 ≤92% (false negative and false positive rates at SpO2 ≤92% and ≤94%, AUC, occult hypoxaemia) of five pulse oximeters
Methodological detailsmulticentre, 24 ICUs in England, June 2022 to August 2024
- Multicentre
- 24 ICUs in England, June 2022 to August 2024
Performance
As reported in the abstract
SpO2 overestimation and false negative rate (SpO2 >94% despite SaO2 ≤92%) by skin tone
Rate ratio
2.3-7.1
5.3 to 35.3 percentage points higher false negative rate
Difference
0.6-1.5 percentage points
SpO2 readings higher on average
Darker skin tone
7.6-62.2%
Lighter skin tone
1.2-26.9%
Original publication
The impact of skin tone on performance of pulse oximeters used by NHS England COVID Oximetry @home scheme: measurement and diagnostic accuracy study. BMJ. Published 14 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →