Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Bad Advice on Masimo’s RAD-57 – Part II

Also posted over at Paramedicine 101 (now at EMS Blogs). Go check out the rest of the excellent material there.

Continuing from Bad Advice on Masimo’s RAD-57 – Part I.

Medic Marshall adds this little bit of commentary to what was covered in Part I

When I dug a little deeper and looked at the study’s limitations, I saw that the authors noted approximately three quarters of the subjects were of Hispanic or African descent. The RAD-57 device has already been shown to have poor performance when measuring carboxyhemoglobin in dark-pigmented individuals. A significant potential for bias (at least in my humble opinion) exists in this study. Take it for what it’s worth; I personally don’t give it a whole lot of merit.[1]

Wow.

We should only use this on pale skinned people? Is that the idea?

Should Masimo avoid advertising this to fire departments with significant numbers of non-white firefighters?

A significant potential for bias (at least in my humble opinion) exists in this study review. Take it for what it’s worth; I personally don’t give it a whole lot of merit.

He admits that the RAD-57 is inaccurate, but he claims that the inaccuracy of the RAD-57 is a demonstration of accuracy.

In the study being reviewed,[2] we have the RAD-57 being used in almost ideal circumstances – not in the poorly controlled EMS environment – and it is still not even close to accurate, but we shouldn’t criticize, because we don’t expect it to be accurate.

Don’t criticize the RAD-57 for being inaccurate. Nobody expects it to be accurate.

That is not a defense I was expecting. This is a, Well that depends on what your definition of accuracy is, defense.

He does score pretty high on the chutzpah meter and that chutzpah meter doesn’t have objective confirmation of accuracy, either.

To be continued in Bad Advice on Masimo’s RAD-57 – Part III and finished in Bad Advice on Masimo’s RAD-57 – Part IV.

Footnotes:

[1] RAD-57 Pulse Oximeter Performance – Study measures device’s readings comared with lab measurement
JEMS Street Science
by Keith Wesley, MD, FACEP and Marshall J. Washick, BAS, NREMT-P
Tuesday, February 15, 2011
Article

[2] Performance of the RAD-57 pulse CO-oximeter compared with standard laboratory carboxyhemoglobin measurement.
Touger M, Birnbaum A, Wang J, Chou K, Pearson D, Bijur P.
Ann Emerg Med. 2010 Oct;56(4):382-8. Epub 2010 Jun 3.
PMID: 20605259 [PubMed – indexed for MEDLINE]

Free Full Text Article from Ann Emerg Med with links to Free Full Text PDF download

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  2. […] Continuing from Bad Advice on Masimo’s RAD-57 – Part I and from Bad Advice on Masimo’s RAD-57 – Part II. […]

  3. […] be continued in Bad Advice on Masimo’s RAD-57 – Part II and later continued in Bad Advice on Masimo’s RAD-57 – Part III and finished in Bad […]