UTA researchers begin developing blood measuring device to combat racial bias, health care inequity

Bioengineering associate professor George Alexandrakis sits for a portrait Nov. 11 at the Engineering Research Building. The UTA research team is attempting to factor out the absorption through skin components and use blue and green wavelengths to get a better measurement of blood parameters.

UTA scientists are developing a wristwatch-like blood measuring device to tackle health care inequity that affects communities of color. 

Bioengineering associate professor George Alexandrakis and Sanjay Gokhale, a research scientist in the Bioengineering Department, are working with a biotechnology company in Austin on a prototype to better measure hemoglobin in individuals with darker skin tones. Hemoglobin is the part of the blood that carries oxygen to tissues.   

Current pulse oximeters measure one’s blood by sending infrared wavelengths through the skin and absorbing the lights that bounce back, Alexandrakis said. But different skin tones absorb light differently. 

People with darker skin tones have a higher light absorption rate, he said, which would cause pulse oximeters to misread the blood parameters. 

The UTA research team is attempting to factor out the absorption through skin components and use blue and green wavelengths to better measure blood parameters. 

The darker an individual’s skin tone is, the more difficult it becomes for the sensor, Alexandrakis said. It’s an internal bias in all such medical devices. 

If a Black person used a current pulse oximeter and received inaccurate data of their blood oxygenation, the doctor may then deduce they’re not hypoxic enough to receive treatment, he said. The mismeasurement and negligence would cause the person’s illness to develop into a more severe case. 

The team has tested the prototype on about 30 healthy participants for an initial trial. Preliminary results suggested the device can estimate hemoglobin concentration with better accuracy and consistency than current devices available in the medical field, Alexandrakis said. 

Vinoop Daggubati, the sponsor of the invention and owner of Shani Biotechnologies, LLC, said current medical technologies have neglected how they treat and monitor hemoglobin in people of color. 

The device they are developing aims to measure people of color as accurately as current technology can for white people, Daggubati said.  

According to the study titled “Racial Bias in Pulse Oximetry Measurement,” published December 2020 in The New England Journal of Medicine, Black people are three times more likely than white people to experience pulse oximeter errors. And that could translate into as many as one in 10 inaccurate readings among Black people.

The study, carried out by researchers from the University of Michigan Medical School, prompted the U.S. Senate to urge the Food and Drug Administration in a letter to further research the interaction between a patient’s skin color and the accuracy of the device’s measurements. 

“Racial disparities in health care stem from a wide variety of factors, and it is particularly disturbing that racism may be embedded in key clinical tools,” said the letter with endorsement from Senators Elizabeth Warren of Massachusetts, Ron Wyden of Oregon and Cory Booker of New Jersey. 

The study also sparked a dialogue on word choices. 

“Racial bias always refers to decisions influenced by a person’s race,” a doctor from the U.K. argued, and medical devices like pulse oximeters “are blind to color and cannot exhibit such a bias.” 

But the inaccuracy in pulse oximeters has been documented for three decades, the authors of the study countered, and the problem still remains neither fully corrected nor widely known. 

When the device is systematically less accurate in Black people than in white people, the authors said, this design flaw results in racial bias, intentional or not.  

In addition to improving health care equity, UTA’s research team aims to miniaturize the technology into a calibrated wristwatch, said Gokhale, who is also the sole inventor of the device. 

There’s no such wearable device in the market yet, Alexandrakis said. 

It’s necessary to monitor patients periodically, Gokhale said. The standard modality is to conduct blood draws on patients, but that’s painful and particularly difficult to draw blood from babies. 

“If you can measure something without piercing somebody many times, that’s huge for a person’s well being and avoiding infection,” Alexandrakis said.  

The device would be beneficial for people who are afraid of needles or have hemophobia, the fear of blood, Daggubati said. It would also provide real time data to monitor patients closely and remotely. 

Patients who receive chemotherapy would usually need to check into clinics after their session to see if they have anemia, a side effect from chemotherapy, he said. But having the device can and will tell patients such results with no need of clinic visits. 

Individuals can then decide when to get treated at the appropriate time, Alexandrakis said. Subsequently they would have a better chance at preventing an illness going from bad to worse. 

They are deciding the next steps of the research, which may include testing the technology on patients, possibly from Arlington hospitals, he said. 



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