Experts argue that because women, persons of color, and those from low-income families are shown to be more likely to have inferior healthcare, action is required.
According to a survey, biases in medical equipment and technologies put women, persons of color, and residents of underprivileged areas at risk of receiving subpar treatment.
The Equity in Medical Devices: Independent Review has identified many issues, including devices that monitor oxygen levels and those that use artificial intelligence (AI). The evaluation panel declared that immediate action was required.
“We’d like an equity lens on the entire lifecycle of medical devices, from the initial testing, to the recruitment of patients either in hospital or in the community, into the early phase studies and the implementation in the field after they are licensed,” stated Prof. Frank Kee, director of the Queen’s University Belfast Center for Public Health and a co-author of the review.
“Ensuring the healthcare system functions for everyone, regardless of ethnicity, is paramount to our values as a nation,” said Andrew Stephenson, junior health minister. It helps in our broader efforts to establish a more equitable and straightforward NHS.
When Sajid Javid was health minister in 2022, questions were expressed over the accuracy of pulse oximeter readings among Black and minority ethnic persons. As a result, the government commissioned an inquiry.
Low oxygen levels were a crucial indicator of a severe sickness during the Covid epidemic, which brought the commonly used devices into the public eye.
While there was no evidence that this had an impact on care in the NHS, the report has confirmed concerns that pulse oximeters overestimate the amount of oxygen in the blood of people with dark skin. It also notes that harm has been found in the US with such biases leading to delayed diagnosis and treatment, worse organ function, and death in Black patients.
The group members emphasize that they are not advocating for avoiding the gadgets. Rather than focusing on individual readings, the review suggests several ways to enhance the use of pulse oximeters in individuals with varying skin tones. It also offers guidance on how to design and test new devices to guarantee that they are effective for patients of all ethnicities.
The report also raised concerns about AI-based devices, pointing out that these devices could worsen women’s underdiagnosis of cardiac conditions, cause discrimination based on patients’ socioeconomic status, and cause people with darker skin tones to be underdiagnosed with skin cancers. They claim the reason for their concerns about the latter is because AI systems are mostly trained on pictures of people with lighter skin tones.
The study also identified issues with polygenic risk scores, which are often used to estimate a person’s genetically based illness risk.
Enitan Carrol, a professor of paediatric infection at the University of Liverpool and a co-author of the study, said that the majority of the genetic datasets used by polygenic risk scores are based on individuals of European origin, meaning that they may not be relevant to persons of different cultures.
