The Affordable Care Act's Call for Nondiscrimination: Addressing the Role of Pulse Oximetry in Racial Disparities

Howard L Saft^{1

2}, Nirav R Bhakta³, An-Kwok Ian Wong^{4

5}, Sharron J Crowder⁶, Stuart C Sweet⁷, Indira Gurubhagavatula^{8

9}

Affiliations

¹ National Jewish Health, Denver, Colorado.
² University of Colorado School of Medicine, Aurora, Colorado.
³ University of California San Francisco, San Francisco, California.
⁴ Duke University Medical Center, Durham, North Carolina.
⁵ Durham VA Medical Center, Durham, North Carolina.
⁶ Indiana University School of Nursing, Indianapolis, Indiana.
⁷ School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
⁸ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
⁹ Crescenz VA Medical Center, Philadelphia, Pennsylvania.

Howard L Saft et al. Ann Am Thorac Soc. 2025 Mar.

. 2025 Mar;22(3):313-316.

doi: 10.1513/AnnalsATS.202408-902PS.

Howard L Saft^{1

2}, Nirav R Bhakta³, An-Kwok Ian Wong^{4

5}, Sharron J Crowder⁶, Stuart C Sweet⁷, Indira Gurubhagavatula^{8

9}

¹ National Jewish Health, Denver, Colorado.
² University of Colorado School of Medicine, Aurora, Colorado.
³ University of California San Francisco, San Francisco, California.
⁴ Duke University Medical Center, Durham, North Carolina.
⁵ Durham VA Medical Center, Durham, North Carolina.
⁶ Indiana University School of Nursing, Indianapolis, Indiana.
⁷ School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
⁸ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
⁹ Crescenz VA Medical Center, Philadelphia, Pennsylvania.

No abstract available

Figures

Lest a Smoky Haze of Doubt Suffocate Progress toward Better Pulse Oximeters.
Iwashyna TJ, Hauschildt KE, Ni V, Lynch J, Tomori C. Iwashyna TJ, et al. Ann Am Thorac Soc. 2025 Mar;22(3):322-324. doi: 10.1513/AnnalsATS.202411-1213ED. Ann Am Thorac Soc. 2025. PMID: 39700509 Free PMC article. No abstract available.

1. U.S. Department of Health and Human Services Office of Civil Rights. Nondiscrimination in health programs and activities. 2024. https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscr...
1. Jamali H, Castillo LT, Morgan CC, Coult J, Muhammad JL, Osobamiro OO, et al. Racial disparity in oxygen saturation measurements by pulse oximetry: evidence and implications. Ann Am Thorac Soc . 2022;19:1951–1964. - PubMed
1. Sjoding MW, Iwashyna TJ, Valley TS. Change the framework for pulse oximeter regulation to ensure clinicians can give patients the oxygen they need. Am J Respir Crit Care Med . 2023;207:661–664. - PMC - PubMed
1. Wong A-KI, Charpignon M, Kim H, Josef C, de Hond AAH, Fojas JJ, et al. Analysis of discrepancies between pulse oximetry and arterial oxygen saturation measurements by race and ethnicity and association with organ dysfunction and mortality. JAMA Netw Open . 2021;4:e2131674. - PMC - PubMed
1. Fawzy A, Wu TD, Wang K, Robinson ML, Farha J, Bradke A, et al. Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19. JAMA Intern Med . 2022;182:730–738. - PMC - PubMed