From Bias to Equity: Rethinking Medical Device Development

The letter highlights the challenge facing technology developers in how to consider equity in the design and deployment of new medical devices. 

The COVID-19 pandemic drew attention to how pulse oximeters - which measure blood oxygen levels - may not be as accurate for patients with darker skin tones compared with those with lighter skin.

In response, the then Secretary of State for Health and Social Care commissioned an independent review, chaired by Prof. Dame Margaret Whitehead, to consider the evidence for bias in pulse oximeters and in other medical devices, including diagnostic devices enabled by artificial intelligence (AI).

The resulting report revealed clear evidence for differential performance of medical devices between socio-demographic groups that had the potential to lead to poorer healthcare for the population group disadvantaged by the bias. While the report stresses that this bias was largely unintentional (for example related to unrepresentative datasets in AI algorithms, compounded by testing and evaluation in predominantly male, White populations), the findings raise an important question and challenge to the developers of technology; How do we innovate future medical devices so that the benefits of that technology are distributed equitably across society? This is precisely the question that the ETL has been considering.

Our letter to The Guardian lays out our way of thinking about technology development as both a technical and societal challenge that can only be resolved by adopting an inclusive and participatory approach to research in which a diverse range of participants are embedded at all stages of the innovation
process.

You can read our full response here.