Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults

OBJECTIVE: The purposes of the study were to: (1) describe the aggregate strength of the relationship of arterial oxygen saturation as measured by pulse oximetry with the standard of arterial blood gas analy-sis as measured by co-oximetry, (2) examine how various factors affect his relationship, and (3) describe an aggregate estimate of the bias and precision between oxygen saturation as measured by pulse oxime-try and the standard in vitro measures. DESIGN: A meta-analysis was conducted. SAMPLE: Seventy-four studies from 1976 to 1994 met the inclusion criteria of: (I) adult study popula-tion, (2) quantitative analysis of empirical data, and (3) bivariate correlations or bias and precision esti-mates between pulse oximeter and co-oximeter values. RESULTS: There were a total of I69 oximeter trials on 41 oximeter models from 25 different manufac-turers. Studies were conducted in various settings with a variety of subjects, with most being healthy adult yolunteers. The weighted mean r, based on 39 studies (62 oximeter trials) for which the r statistic and number of data points were available, was 0.895 (var [r] = 0.014). Based on 23 studies (82 oxime-ter trims) for which bias and precision estimates and number Of data points were available, the mean absolute bias and precision were 1.999 and 0.233, respectively. Several factors were found to affect th