{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:13:44Z","timestamp":1788135224212,"version":"build-2803163510"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Pulse-oximeter oxygen saturation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      ) is widely used in outpatient respiratory care because it is fast and noninvasive, but arterial blood gas (ABG) testing provides a more direct measure of arterial oxygen saturation (SaO\n                      <jats:sub>2<\/jats:sub>\n                      ). Prior studies show that pulse oximeters may overestimate oxygen saturation in individuals with darker skin tones, potentially leading to missed recognition of clinically meaningful hypoxemia. However, limited research has examined measurement agreement in outpatient occupational lung disease settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective agreement analysis was conducted using paired ABG-derived SaO\n                      <jats:sub>2<\/jats:sub>\n                      and pulse-oximeter SpO\n                      <jats:sub>2<\/jats:sub>\n                      measurements from the same outpatient visit at a rural West Virginia Black Lung Clinic. Paired measurements were defined as SaO\n                      <jats:sub>2<\/jats:sub>\n                      and SpO\n                      <jats:sub>2<\/jats:sub>\n                      readings recorded during the same clinical encounter. Agreement was evaluated using the Bland-Altman approach, which quantifies the average difference between two methods (mean bias) and the range within which most individual differences are expected to fall (limits of agreement). Hidden hypoxemia was defined as SaO\n                      <jats:sub>2<\/jats:sub>\n                      \u2264 88% with concurrent SpO\n                      <jats:sub>2<\/jats:sub>\n                      \u2265 90% or \u2265 92%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-five participants were included; all male and self-identified as African American. Mean age was 70.7 years (SD 8.9). At rest, pulse oximetry overestimated SaO\n                      <jats:sub>2<\/jats:sub>\n                      by an average of 1.29 percentage points (SD 3.74), with 95% limits of agreement from \u22126.04 to +8.62 percentage points. Following exercise, mean bias was +0.75 percentage points (SD 3.68), with limits of agreement from \u22126.46 to +7.96. Although average differences were modest, individual discrepancies were sometimes several percentage points higher or lower than ABG values. ABG-defined hypoxemia occurred in 1\/35 participants at rest and 1\/34 post-exercise; in both cases, SpO\n                      <jats:sub>2<\/jats:sub>\n                      remained \u2265 90% and \u2265 92%, consistent with hidden hypoxemia. Regression analysis did not demonstrate statistically significant proportional bias at either timepoint.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this outpatient Black Lung Clinic sample, pulse oximetry averaged only modest overestimation of SaO\n                      <jats:sub>2<\/jats:sub>\n                      , but individual readings varied widely. This matters because oxygen and disability-related decisions are made one patient at a time, and differences of several percentage points can change classification near common thresholds. These findings support cautious interpretation and use of pulse-ox values in outpatient occupational lung disease care and justify larger, multi-site studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261485526","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:28:14Z","timestamp":1787941694000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulse Oximetry and Arterial Blood Gas Agreement in an Outpatient Black Lung Clinic: Implications for Clinical Assessment and Decision Making"],"prefix":"10.1177","volume":"17","author":[{"given":"Sarah","family":"Hansen","sequence":"first","affiliation":[{"name":"Cabin Creek Health Systems"},{"name":"West Virginia Alliance for Creative Health Solutions, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7149-6866","authenticated-orcid":false,"given":"Katherine","family":"Burchfield","sequence":"additional","affiliation":[{"name":"West Virginia Alliance for Creative Health Solutions, Inc."},{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Hupp","sequence":"additional","affiliation":[{"name":"Cabin Creek Health Systems"},{"name":"West Virginia Alliance for Creative Health Solutions, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Haroon","family":"Yousuf","sequence":"additional","affiliation":[{"name":"Cabin Creek Health Systems"},{"name":"West Virginia Alliance for Creative Health Solutions, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-3680","authenticated-orcid":false,"given":"Adam","family":"Baus","sequence":"additional","affiliation":[{"name":"West Virginia Alliance for Creative Health Solutions, Inc."},{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23431"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23519"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304517"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-043021-024004"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac164"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005394"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000285988.35174.d9"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.1906"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.30856"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000825"},{"key":"e_1_3_6_12_2","volume-title":"Chapter 6\u2014Definition of Coal Miner and Length of Coal Mine Employment","unstructured":"U.S. Department of Labor, Office of Administrative Law Judges. Judges\u2019 Benchbook: Black Lung Benefits Act, Chapter 6\u2014Definition of Coal Miner and Length of Coal Mine Employment. Published 2013. Accessed April 10, 2026.https:\/\/www.dol.gov\/sites\/dolgov\/files\/oalj\/PUBLIC\/BLACK_LUNG\/REFERENCES\/REFERENCE_WORKS\/BLA_Benchbook_Chapter_06_(2013).pdf"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2015.015"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/MDER.S47319"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202009-3608ST"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00272-2021"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202209-837OC"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261485526","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319261485526","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261485526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T23:18:56Z","timestamp":1788131936000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319261485526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":17,"alternative-id":["10.1177\/21501319261485526"],"URL":"https:\/\/doi.org\/10.1177\/21501319261485526","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"21501319261485526"}}