University of Alabama at Birmingham School of Medicine, United States of America.
Greenville Health System, United States of America.
Am J Emerg Med. 2020 May;38(5):925-928. doi: 10.1016/j.ajem.2019.07.020. Epub 2019 Jul 15.
To determine if a correlation exists between 3 iphone pulse ox applications' measurements and the standard pulse oximetry (SpO2) and whether these applications can accurately determine hypoxia.
Three applications reportedly measuring SpO2 were downloaded onto an iPhone 5s. Two of these applications used the onboard light and camera lens "Pulse Oximeter" (Pox) and "Heart Rate and Pulse Oximeter" (Ox) and one used an external device that plugged into the iphone (iOx). Patients in the ED were enrolled with chief complaints of cardiac/pulmonary origin or a SpO2 ≤ 94%. All measurements were compared to controls. Concordance correlation coefficients, sensitivity, and specificity were calculated.
A total of 191 patients were enrolled. The concordance correlation of iOx with control was 0.55 (CI 0.46, 0.63), POx was 0.01 (CI -0.09, 0.11), and Ox was 0.07 (CI -0.02, 0.15). 68/191 patients (35%) were found to have hypoxemia. Sensitivities for detecting hypoxia were 69%, 0%, and 7% for iOx, POx, and Ox, respectively. Specificities were 89%, 100%, and 89%. Even iOx (the most accurate) 21 (11%) were incorrectly classified nonhypoxic, and 22 (12%) were incorrectly classified hypoxic.
While iOx has modest concordance with control, Ox and POx showed almost none. The iOx device was best in correctly identifying hypoxia patients, but almost 1/4 of patients were incorrectly classified. The three apps provided inaccurate SpO2 measurements and had limited to no ability to accurately detect hypoxia. These apps should not be relied upon to provide accurate SpO2 measurements in emergent, even austere conditions.
确定 3 款 iphone 脉搏血氧仪应用程序的测量值与标准脉搏血氧饱和度（SpO2）之间是否存在相关性，以及这些应用程序是否能够准确地确定缺氧。
将据称可测量 SpO2 的 3 款应用程序下载到 iPhone 5s 上。其中 2 款应用程序使用内置的光和摄像头镜头“脉搏血氧仪”（Pox）和“心率和脉搏血氧仪”（Ox），另 1 款应用程序使用插入 iphone 的外部设备（iOx）。急诊科有心脏/肺部主诉或 SpO2≤94%的患者入组。所有测量值均与对照值进行比较。计算了一致性相关系数、灵敏度和特异性。
共纳入 191 例患者。iOx 与对照的一致性相关系数为 0.55（CI 0.46，0.63），POx 为 0.01（CI -0.09，0.11），Ox 为 0.07（CI -0.02，0.15）。68/191 例（35%）患者被发现存在低氧血症。检测缺氧的敏感性分别为 iOx 69%、POx 0%和 Ox 7%。特异性分别为 iOx 89%、POx 100%和 Ox 89%。即使是 iOx（最准确的），也有 21 例（11%）被错误地归类为非缺氧，22 例（12%）被错误地归类为缺氧。
虽然 iOx 与对照具有适度的一致性，但 Ox 和 POx 几乎没有。iOx 设备最擅长正确识别缺氧患者，但近 1/4 的患者被错误分类。这 3 款应用程序提供的 SpO2 测量值不准确，几乎无法准确检测缺氧。在紧急情况下，即使是在简陋的条件下，也不能依赖这些应用程序提供准确的 SpO2 测量值。
