ENCoDE, mEasuring skiN Color to correct pulse Oximetry DisparitiEs: skin tone and clinical data from a prospective trial on acute care patients.

The wide adoption of pulse oximeters has given clinicians an easy, non-
invasive way to measure arterial oxygen saturation. However, evidence suggests
that pulse oximeter measurements have a deeper discrepancy in patients of
darker skin tones compared to their lighter counterparts. It has been
hypothesized that skin tone is the root cause of this phenomenon. However,
skin tone as a medical concept has not been extensively studied in acute care.

Our study included patients admitted to Duke University Hospital with pulse
oximetry recorded up to 5 minutes prior to arterial blood gas (ABG)
measurements. Skin tone was measured across sixteen body locations using
administered visual scales (Fitzpatrick, Monk Skin Tone, and Von Luschan),
reflectance colorimetry (Delfin SkinColorCatch), and reflectance
spectrophotometry (Konica Minolta CM-700D, Variable Spectro 1). IPhone SE 2020
and Google Pixel 4 (Android) image data are available for non-biometric body
locations.

One hundred twenty-eight patients are enrolled in this study. A total of 167
skin tone variables and two temperature variables are collected per body
location, excluding images, together with ten non-biometric body location
images per patient and the associated electronic health record (EHR) data. The
ENCoDE project is a comprehensive EHR-linked skin tone database to combat skin
tone associate disparities.