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Updated: May 10, 2026

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response
Published on: October 3, 2019
Clinician behavior when skin tone affects test results
Marcella Alsan1,2, Liran Einav1,2, Amy Finkelstein2,3
1Department of Economics, Stanford University, Stanford, CA 94305.
Abstract:
We compare care for Black vs. White patients following pulse oximetry, a widely used device for measuring blood oxygen levels which overestimates oxygen saturation in darker-skinned patients. Black patients are therefore medically more appropriate for follow-up care than White patients with the same pulse oximetry reading. Yet, using data from the Veterans Health Administration on 3.5 million emergency department visits between 2014 and 2018, we find that Black patients systematically receive lower rates of follow-up care than White patients with the same reading. Our findings illustrate how bias in a medical screening device can be propagated and potentially amplified in downstream care.
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