What question did this study set out to answer?

To evaluate and compare the accuracy and precision of seven over-the-counter finger pulse oximeters in measuring oxygen saturation against reference arterial blood gas values.

June 6, 2025Philippine journal of chest diseasesOpen Access

Pilot Study on the Comparison of Seven Commonly Used Over-the-Counter Pulse Oximeter Finger Devices

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Patients requiring arterial blood gas testing (n=107). Intervention: Seven over-the-counter pulse oximeter finger devices vs. Arterial blood gas oxygen saturation (SaO2). Primary outcome: Accuracy measured by average root mean square error (ARMS).

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Key result

ChoiceMMed MD300C29 proves the most accurate OTC pulse oximeter, though all lose accuracy in hypoxemic patients.

n=107

Why the study?

Over-the-counter pulse oximeters are commonly used in patient care but had not yet been evaluated for their accuracy and precision.

Do over-the-counter pulse oximeter finger devices accurately and precisely measure oxygen saturation compared to arterial blood gas in adult patients?

Population

107 participants aged 18 and above

Comparison

Seven over-the-counter pulse oximeter finger devices vs arterial blood gas SaO2

Design

Cross-sectional study

Authors

SSSara Kristel SungahidChang Hua Hospital ARAlbert L. RafananChang Hua Hospital

Discussion

Member takes

Implication

Caution against unverified OTC oximeter use in hypoxemia; leaves open need for prospective device validation.

Key Points

To evaluate and compare the accuracy and precision of seven over-the-counter finger pulse oximeters in measuring oxygen saturation against reference arterial blood gas values.
Conducted a cross-sectional study of 107 participants aged 18 and older from June to November 2023.
Compared finger pulse oximeter SpO2 readings against arterial blood gas SaO2 measurements using mean bias, standard deviation, and average root mean square error (ARMS).
Performed a subgroup analysis on patients presenting with hypoxemia, defined as SaO2 <95%.
ChoiceMMed MD300C29 demonstrated the highest accuracy with an ARMS of 1.89% and the lowest standard deviation (±1.84), while Yongrow showed the lowest mean bias (0.21).
IMDK exhibited the poorest precision and accuracy, recording the highest mean bias (-0.90) and the largest standard deviation (±2.47).
Subgroup analysis of patients with hypoxemia (SaO2 <95%) revealed significant biases along with lower precision and accuracy across all seven tested devices.

Study Design

Type

Cross-Sectional (n=107)

Multicenter

Structured PICO

Do over-the-counter pulse oximeter finger devices accurately and precisely measure oxygen saturation compared to arterial blood gas in adult patients?

Population

107 adults (aged 18 and above) scheduled for arterial blood gas (ABG) testing, mean age 63, 78% male, 95% Asian, at a single center in the Philippines. Inclusion: axillary temperature >35°C, hemoglobin >9 g/dL, mean arterial pressure >60 mmHg. Exclusion: dyshemoglobinemia, nail polish/artificial fingernails, finger clubbing, peripheral vascular disease, IV dyes in past 7 days.

Intervention

Measurement of peripheral oxygen saturation (SpO2) using seven over-the-counter pulse oximeter finger devices (ChoiceMMed MD300C13, ChoiceMMed MD300C29, ChoiceMMed MD300C5, INDOPLAS, Contec CMS50ED, Yongrow YK-83LED, IMDK C101A3).

Comparator

Arterial blood gas oxygen saturation (SaO2) as the reference standard.

Outcome

Accuracy (assessed through average root mean square error [ARMS]) and precision (mean bias and standard deviation) of SpO2 compared to SaO2.surrogate

Over-the-counter pulse oximeters vary significantly in accuracy and precision, with performance notably degrading during hypoxemia, cautioning against their unverified clinical reliance.

Limitations

Single-center pilot study using convenience sampling
Sole data collector increasing risk of human error and single-observer bias
Restricted variability in SaO2 with most patients exceeding 95%
Underpowered analysis due to small sample size (107 instead of 200)
Lacked blinding
Single-center pilot study with convenience sampling
Single data collector leading to potential single-observer bias
Restricted variability in SaO2 (mostly >95%)
Underpowered analysis (did not meet FDA sample size of 200)

Cite This Study

Sungahid et al. (2025) conducted a cross-sectional in Patients requiring arterial blood gas testing (n=107). Seven over-the-counter pulse oximeter finger devices vs. Arterial blood gas oxygen saturation (SaO2) was evaluated on Accuracy measured by average root mean square error (ARMS). Among seven over-the-counter pulse oximeters, ChoiceMMed MD300C29 was the most accurate with an average root mean square error of 1.89%, though all devices showed decreased precision and accuracy in hypoxemic patients.

synapsesocial.com/papers/6a0960f916dfdfe7ed340a36 https://doi.org/10.70172/pjcd.v23i1.10201

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Pilot Study on the Comparison of Seven Commonly Used Over-the-Counter Pulse Oximeter Finger Devices

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Pilot Study on the Comparison of Seven Commonly Used Over-the-Counter Pulse Oximeter Finger Devices

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider