Just when the federal government was beginning to make progress on addressing racial inequities related to pulse oximeters, the Trump administration’s attacks on diversity, equity, and inclusion initiatives pose a threat to halt these efforts.
Dr. Michael Lipnick, an anesthesiologist at the University of California, San Francisco, who focuses on figuring out how pulse oximeters work on different skin tones, expressed his concern. We have been attempting to determine the next source of funding.
Historically, federal health agencies like the U.S. Agency for International Development (USAID) and the Food and Drug Administration have provided 80% of Lipnick’s research funding.
That money’s future is now in doubt. Last week, President Donald Trump issued an executive order prohibiting DEI initiatives just hours after taking the oath of office for a second term. Although the main focus of that directive was on hiring practices, there is worry that it may have an impact on pulse oximeter studies that aim to increase the proportion of participants with darker skin tones.
In other words, how can researchers follow new guidelines to avoid focusing on race while still looking for persons of color to address research gaps?
Federal health experts who want to know if they can continue their study have been thwarted by recent orders to stop scientific communications from federal health departments. The Department of Health and Human Services, which is in charge of all federal health agencies, did not immediately respond to a request for comment.
Dr. Theodore Iwashyna, a professor at the Johns Hopkins Bloomberg School of Public Health and a critical care physician, said, “I think I’ve spent about twenty-five hours in the past week talking with my colleagues as we try to understand what these poorly written, obviously immoral, and probably unlawful orders will actually mean.”
Iwashyna co-authored a significant 2020 study that demonstrated how Black patients’ pulse oximeters don’t function as anticipated.
The scientists who are most likely to work to make sure pulse oximeters function better for everyone are the targets of the anti-DEI activities, he said.
Pulse oximeters, which shine a light through the fingertip to find oxygen-rich blood, are frequently used during routine exams. However, skin pigment is also absorbed by that light. People with darker skin tend to have erroneous pulse oximeter values because they appear healthier when they have more pigment.
Although the racial differences in pulse oximeter readings have been recognized for many years, the Covid epidemic sparked a renewed interest in the topic.
In order to resolve the problem, the FDA seems to be concentrating on completing recommendations for pulse oximeter producers. The FDA released draft guidelines earlier this month urging manufacturers to significantly increase the range of skin tones they may test their devices on and show that they function uniformly across all skin hues.
Not all studies on pulse oximeter racial discrepancies are in danger. The Medical University of South Carolina’s Dr. Andrew Goodwin is spearheading a huge study to examine any racial disparities in hospitalized patients’ pulse oximetry measurements.
Given that it has obtained private funding from Masimo, one of the largest producers of pulse oximeters, Goodwin’s work is anticipated to continue.
To date, his study team has enrolled about 200 patients. “So far, our preliminary data set shows a really robust distribution across skin pigment,” Goodwin said. It will take a few more years to see results.
Despite moving his family from San Francisco to Kampala, Uganda, to establish a pulse oximetry lab and investigate how pulse oximeters function on darker skin tones, Lipnick’s research’s future remains uncertain.
New federal funding applications have just been submitted by his team.
“We’re broke right now,” he said. At the intersection of health equity, everyone is wondering what’s going to happen.