Short: Racial Disparities in Pulse Oximetry Cannot Be Fixed With Race-Based Correction

Pulse oximeters play a critical role in health monitoring. Pulse ox measurements have statistical bias that is a function of race, which results in higher rates of occult hypoxemia, i.e., missed detection of dangerously low oxygenation, in patients of color. This paper further characterizes the statistical distribution of pulse ox measurements, showing they also have a higher variance for patients racialized as Black, compared to those racialized as white. By analyzing the performance of hypoxemia detection as a detector, we show that no single race-based correction factor will provide equal performance by race. As a result, for racially equitable pulse oximetry, the pulse oximeter itself must be fixed, not just the hypoxemia thresholds.