A recent report has found that individuals belonging to minority ethnic groups, women, and those living in disadvantaged communities face a higher chance of receiving subpar healthcare due to inherent biases within medical equipment and technology.

The Independent Review on Equity in Medical Devices revealed several concerns, particularly regarding the usage of artificial intelligence and oxygen measurement devices. The review team emphasized the need for immediate action.

Professor Frank Kee, the head of the public health department at Queen’s University Belfast and one of the writers of the analysis, expressed the importance of considering equity throughout the entire lifespan of medical devices. This includes the testing phase, recruiting patients in either a hospital or community setting, conducting early phase studies, and implementing the devices once they are approved for use in the field.

According to Andrew Stephenson, the junior health minister, it is essential for our nation to ensure that the healthcare system serves everyone equally, regardless of their ethnicity. This aligns with our efforts to establish a more equitable and streamlined NHS.

In 2022, while serving as health secretary, Sajid Javid established a government-sponsored evaluation in response to concerns about the precision of pulse oximeter readings specifically in Black and minority ethnic individuals.

The significance of healthcare devices during the Covid-19 pandemic was brought to attention, as they played a crucial role in monitoring low oxygen levels, a key indicator of severe infection.

Recent findings indicate that pulse oximeters may overestimate oxygen levels in individuals with dark skin. This has been shown to contribute to delayed diagnosis and treatment, as well as worse outcomes for Black patients in the US. While there is no evidence of this problem affecting healthcare in the NHS, it is still a concern to be addressed.

The team wants to make it clear that they are not suggesting that the devices should be avoided. Instead, their review suggests various strategies for enhancing the use of pulse oximeters in individuals with varying skin tones. This includes monitoring changes in readings and offering guidance on designing and testing new devices to ensure they are effective for patients from all ethnic backgrounds.

The report also brought attention to concerns regarding AI devices, specifically the possibility of worsening the under-diagnosis of cardiac conditions in women, enabling discrimination based on socioeconomic standing, and contributing to the under-diagnosis of skin cancers in individuals with darker skin tones. The latter concern is attributed to the fact that AI devices are predominantly trained on images of lighter skin tones.

The report also highlighted issues regarding polygenic risk scores, which are frequently utilized to assess an individual’s susceptibility to certain diseases based on their genetic makeup.

Enitan Carrol, a co-author of the review and professor of paediatric infection at the University of Liverpool, stated that the genetic datasets commonly utilized for polygenic risk scores primarily consist of individuals of European descent. This suggests that such scores may not be suitable for those of other ancestries.

Nevertheless, addressing biases can pose challenges. The report points out instances where race-specific adjustments made to readings from spirometers, which are used for evaluating lung health and diagnosing respiratory issues, have been found to possess inherent biases.

Dr. Habib Naqvi, the head of the NHS Race and Health Observatory, expressed his approval of the results. He also noted that the review recognized the urgency for adjustments, fairness evaluations, and stricter guidelines and regulations regarding pulse oximeters and other medical equipment.

He stated that one’s ethnicity or skin color should not determine their access to improved health. Therefore, medical equipment must be suitable for all communities.

The underrepresentation of diversity in health research, the inadequate consideration of equity, and the limited use of co-production methods have resulted in racial discrimination in medical equipment, clinical evaluations, and other healthcare treatments.

Source: theguardian.com