Knowing how the oximeter works - you could also say there’s a high error rate in people (not all are female) with fingernail polish.
Retired EMT here. Standard practice is to remove fingernail polish on the finger used for the pulse ox. Alternatively, you can put the probe on so it reads sideways across the finger, though this isn't as reliable.
Can attest that pulse ox is not as reliable for black people.
People with breathing problems are already stressed about that; put one of these on their finger and it gives them a number to stress about. A very noisy instantaneous window onto a data point that integrates over minutes and matters over hours.
They are a great tool but they are not used well currently.
This seems like an eyebrow raising publication path. It appears that the study was not peer reviewed, but sent as a letter to the editor to NEJM.
It’s not a new idea. The heart rate monitor in an Apple Watch uses the same tech as a pulse oximeter, its performance was reported to be worse on darker skin, whether naturally or through tattoos back in 2015, and that wasn’t a surprise to experts then (https://www.vocativ.com/culture/health-culture/tattoos-apple...)