Weissbrod Rachel, Blake Charlene
Medasense Biometrics Ltd, Ramat Gan, Israel.
Department of Anesthesia at the University of San Francisco, San Francisco, CA, USA.
Med Devices (Auckl). 2024 Nov 13;17:465-469. doi: 10.2147/MDER.S492561. eCollection 2024.
The NOL-Nociception Level Index is a multiparameter index, based on artificial intelligence for the monitoring of nociception (physiological pain response) during anesthesia that has recently been authorized by the FDA. The monitor utilizes continuous streams of information from a finger probe comprising four sensors, including photoplethysmography, to provide a personalized nociception score on a scale of 0-100. Recent studies have suggested racial bias in pulse oximeter measurements due to the effect of melanin levels on photoplethysmography measurements. Therefore, there is a need to clinically validate new monitoring technologies in patients of all skin tones. The performance of the NOL scale in 8 patients that self-identified as Black or multiracial was compared to a database of 447 consented patients, assessing the response to surgical events at different levels of intensity. The descriptive, pilot data suggest that NOL performance in Black and multiracial patients is not different from the performance shown for the large database. Larger studies utilizing recognized skin tone scales to ensure accurate assessment of skin pigmentation are planned for the future.
NOL伤害感受水平指数是一种多参数指数，基于人工智能，用于在麻醉期间监测伤害感受（生理疼痛反应），最近已获得美国食品药品监督管理局（FDA）的批准。该监测仪利用来自包含四个传感器（包括光电容积脉搏波描记法）的手指探头的连续信息流，以0-100的量表提供个性化的伤害感受评分。最近的研究表明，由于黑色素水平对光电容积脉搏波描记法测量的影响，脉搏血氧仪测量中存在种族偏见。因此，有必要在所有肤色的患者中对新的监测技术进行临床验证。将8名自我认定为黑人或多种族的患者的NOL量表表现与447名同意参与的患者数据库进行比较，评估在不同强度水平下对手术事件的反应。描述性的试点数据表明，黑人及多种族患者的NOL表现与大型数据库所示的表现没有差异。计划在未来开展更大规模的研究，利用公认的肤色量表来确保对皮肤色素沉着进行准确评估。
