Sajid Javid orders review into ethnic bias of medical devices

Devices such as pulse oximeters appear to work less well in people with darker skin

22nd November 2021 about a 3 minute read
"Technologies are created and developed by people, and so bias, however inadvertent, can be an issue here too." Sajid Javid, health and social care secretary

The health and social care secretary, Sajid Javid, has ordered a review into the possible ethnic bias of some medical devices.

Research has shown that oximeters, which measure the amount of oxygen in an individual’s bloodstream, can overestimate the level of oxygen in the blood of people with darker skin. This means that they can offer false reassurance that their oxygen levels are safe.

Pulse oximeters beam light through the blood, and skin pigmentation can affect the absorption of light. In people with Covid-19, oxygen levels in the blood can drop dangerously low without people noticing, so during the pandemic the use of a pulse oximeter to measure the oxygen level became very widespread, both in people’s homes and in hospitals.

Announcing the review in the Sunday Times, Javid said it would “look at whether systematic bias exists within current devices, and if so, how we can address it.” The review would “look at all medical devices, and other important biases such as gender bias. For example how we can ensure lifesaving technologies such as MRI scanners can be made accessible to pregnant or breastfeeding women.”

Before Brexit, medical devices for use in the UK had to go through an EU regulatory process. This has changed, Javid said: “We no longer have to follow EU regulations for how these devices are set up, and so we have the opportunity to chart our own course and drive change across the world.”

Inadvertent bias can be an issue

He said that it was “easy to look at a machine and assume that everyone’s getting the same experience. But technologies are created and developed by people, and so bias, however inadvertent, can be an issue here too. So questions like who is writing the code, how a product is tested and who is sitting round the boardroom table are critical — especially when it comes to our health.”

Javid noted that during the first wave of the pandemic, “black, Asian and other minority ethnic groups made up 28 per cent of critical-care admissions in England — about double their representation in the population as a whole.”

He also wanted to fix other disparities, he wrote. A report last week had “highlighted how sickle cell patients, who are primarily from an African or Caribbean background, ‘too often receive sub-standard care’”. Advances in technology in recent years should be “widely shared,” he wrote, “so they help not hinder this work.”

Later, he told the Andrew Marr show that the racial bias in some medical instruments was “unintentional but it exists.” He added: “And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this.”