Exploring the bias: how skin color influences oxygen saturation readings via Monte Carlo simulations.

Significance: Our goal is to understand the root cause of reported oxygen saturation ( ) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs.

Aim: We aim to gain theoretical insights into the effect of skin tone on curves using a three-dimensional, four-layer tissue model representing a finger.

Approach: A finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software.

Pulse oximeter bench tests under different simulated skin tones.

Pulse oximeters' (POs) varying performance based on skin tones has been highly publicised. Compared to arterial blood gas analysis, POs tend to overestimate oxygen saturation (SpO) values for people with darker skin (occult hypoxemia). The objective is to develop a test bench for assessing commercial home and hospital-based POs in controlled laboratory conditions.