Supplementary Material for: Awareness of Racial Bias in Pulse Oximetry Among Practicing Neonatologists: A Cross-Sectional Survey

Introduction:
Pulse oximeters may systematically overestimate arterial oxygen saturation in neonates with darker skin pigmentation. We performed a survey in practicing neonatologists to explore knowledge of this bias and the implications for clinical care.
Methods:
An email survey was distributed assessing knowledge of melanin-related pulse oximeter bias, perceived clinical significance, and communication practices. Responses were compared to data from emergency medicine clinicians.
Results:
Survey results from 120 neonatologists showed that 45.0% agreed that bias exists in pulse oximetry based on skin pigmentation. Among respondents aware of the bias, less than half correctly identified its direction. Most clinicians reported no change in clinical management for dark-skinned neonates. Compared to emergency medicine clinicians, neonatologists changed clinical practice less often and rated discussions with families as less important.
Conclusion:
Awareness of pulse oximetry bias related to skin pigmentation remains limited among neonatologists, with low rates of modification to daily clinical practice.

引言：
脉搏血氧仪（Pulse Oximeter）可能会对肤色较深的新生儿的动脉血氧饱和度出现系统性高估。本研究针对在职新生儿科医师开展了一项问卷调查，旨在探究其对该检测偏差的认知情况，以及该偏差对临床诊疗工作的影响。
方法：
本研究通过电子邮件发放问卷，评估受试者对与黑色素相关的脉搏血氧仪偏差的认知水平、对其临床重要性的主观判断，以及相关沟通实践情况。并将回收的问卷结果与急诊医学医师的相关数据进行对比分析。
结果：
共回收120名新生儿科医师的有效问卷，结果显示仅45.0%的受访者认可肤色相关的脉搏血氧检测偏差的存在。在知晓该偏差的受访者中，不足半数能够正确识别其偏差方向。多数医师表示，不会针对肤色较深的新生儿调整临床诊疗方案。相较于急诊医学医师，新生儿科医师调整临床诊疗行为的频率更低，且认为与患儿家属开展相关沟通的重要性更低。
结论：
新生儿科医师对肤色相关的脉搏血氧检测偏差的认知水平仍然有限，且日常临床诊疗行为的调整率处于较低水平。