Critical Bias in Critical Care Devices

Marie-Laure Charpignon; Joseph Byers; Stephanie Cabral; Leo Anthony Celi; Chrystinne Fernandes; Jack Gallifant; Mary E Lough; Donald Mlombwa; Lama Moukheiber; Bradley Ashley Ong; Anupol Panitchote; Wasswa William; An-Kwok Ian Wong; Lama Nazer

doi:10.1016/j.ccc.2023.02.005

Critical Bias in Critical Care Devices

Crit Care Clin. 2023 Oct;39(4):795-813. doi: 10.1016/j.ccc.2023.02.005. Epub 2023 Mar 27.

Authors

Affiliations

¹ Institute for Data, Systems, and Society (IDSS), E18-407A, 50 Ames Street, Cambridge, MA 02142, USA. Electronic address: mcharpig@mit.edu.
² Respiratory Therapy, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
³ Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
⁴ Laboratory for Computational Physiology, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁵ Laboratory for Computational Physiology, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
⁶ Imperial College London NHS Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
⁷ Stanford Health Care, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
⁸ Zomba Central Hospital, 8th Avenue, Zomba, Malawi; Kamuzu College of Health Sciences, Blantyre, Malawi; St. Luke's College of Health Sciences, Chilema-Zomba, Malawi.
⁹ Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, E25-330, Cambridge, MA 02139, USA.
¹⁰ College of Medicine, University of the Philippines Manila, Calderon hall, UP College of Medicine, 547 Pedro Gil Street, Ermita Manila, Philippines.
¹¹ Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand.
¹² Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
¹³ Duke University Medical Center, 2424 Erwin Road, Suite 1102, Hock Plaza Box 2721, Durham, NC 27710, USA.
¹⁴ King Hussein Cancer Center, Queen Rania Street 202, Amman, Jordan.

PMID: 37704341
DOI: 10.1016/j.ccc.2023.02.005

Abstract

Critical care data contain information about the most physiologically fragile patients in the hospital, who require a significant level of monitoring. However, medical devices used for patient monitoring suffer from measurement biases that have been largely underreported. This article explores sources of bias in commonly used clinical devices, including pulse oximeters, thermometers, and sphygmomanometers. Further, it provides a framework for mitigating these biases and key principles to achieve more equitable health care delivery.

Keywords: Artificial intelligence; Bias; Critical care; Medical devices.

Publication types

Review

MeSH terms

Bias
Critical Care*
Humans