Racial Biases Associated With Pulse Oximetry: Longitudinal Social Network Analysis of Social Media Advocacy Impact

Pulse oximetry is a noninvasive method widely used in critical care and various clinical settings to monitor blood oxygen saturation. During the COVID-19 pandemic, its application for at-home oxygen saturation monitoring became prevalent. Further investigations found that pulse oximetry devices show decreased accuracy when used on individuals with darker skin tones. This study aimed to investigate the influence of X (previously known as Twitter) on the dissemination of information and the extent to which it raised health care sector awareness regarding racial disparities in pulse oximetry.

This study aimed to explore the impact of social media, specifically X, on increasing awareness of racial disparities in the accuracy of pulse oximetry and to map this analysis against the evolution of published literature on this topic.

We used social network analysis drawing upon Network Overview Discovery and Exploration for Excel Pro (NodeXL Pro; Social Media Research Foundation) to examine the impact of X conversations concerning pulse oximetry devices. Searches were conducted using the Twitter Academic Track application programming interface (as it was known then). These searches were performed each year (January to December) from 2012 to 2022 to cover 11 years with up to 52,052 users, generating 188,051 posts. We identified the nature of influencers in this field and monitored the temporal dissemination of information about social events and regulatory changes. Furthermore, our social media analysis was mapped against the evolution of published literature on this topic, which we located using PubMed.

Conversations on X increased health care awareness of racial bias in pulse oximetry. They also facilitated the rapid dissemination of information, attaining a substantial audience within a compressed time frame, which may have impacted regulatory action announced concerning the investigation of racial biases in pulse oximetry. This increased awareness led to a surge in scientific research on the subject, highlighting a growing recognition of the necessity to understand and address these disparities in medical technology and its usage.

Social media platforms such as X enabled researchers, health experts, patients, and the public to rapidly share information, increasing awareness of potential racial bias. These platforms also helped connect individuals interested in these topics and facilitated discussions that spurred further research. Our research provides a basis for understanding the role of X and other social media platforms in spreading health-related information about potential biases in medical devices such as pulse oximeters.