Electronic health record data is unable to effectively characterize measurement error from pulse oximetry: a simulation study.
J Clin Monit Comput
; 38(4): 893-899, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38460103
ABSTRACT
Large data sets from electronic health records (EHR) have been used in journal articles to demonstrate race-based imprecision in pulse oximetry (SpO2) measurements. These articles do not appear to recognize the impact of the variability of the SpO2 values with respect to time ("deviation time"). This manuscript seeks to demonstrate that due to this variability, EHR data should not be used to quantify SpO2 error. Using the MIMIC-IV Waveform dataset, SpO2 values are sampled from 198 patients admitted to an intensive care unit and used as reference samples. The error derived from the EHR data is simulated using a set of deviation times. The laboratory oxygen saturation measurements are also simulated such that the performance of three simulated pulse oximeter devices will produce an average root mean squared (ARMS) error of 2%. An analysis is then undertaken to reproduce a medical device submission to a regulatory body by quantifying the mean error, the standard deviation of the error, and the ARMS error. Bland-Altman plots were also generated with their Limits of Agreements. Each analysis was repeated to evaluate whether the measurement errors were affected by increasing the deviation time. All error values increased linearly with respect to the logarithm of the time deviation. At 10 min, the ARMS error increased from a baseline of 2% to over 4%. EHR data cannot be reliably used to quantify SpO2 error. Caution should be used in interpreting prior manuscripts that rely on EHR data.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Simulação por Computador
/
Oximetria
/
Registros Eletrônicos de Saúde
Limite:
Humans
Idioma:
En
Revista:
J Clin Monit Comput
Assunto da revista:
INFORMATICA MEDICA
/
MEDICINA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos