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BackgroundIn light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical formulae that demonstrate either evidence of bias or suboptimal performance, identifies potential mechanisms behind such bias, and proposes potential methods or avenues that can guide future efforts to address these disparities. ApproachMechanisms are broadly grouped intophysical and biological biases(e.g., pulse oximetry, non-contact infrared thermometry [NCIT]),interaction of human factors and cultural practices(e.g., electroencephalography [EEG]), andinterpretation bias(e.g, pulmonary function tests [PFT], optical coherence tomography [OCT], and Humphrey visual field [HVF] testing). This review scope specifically excludes technologies incorporating artificial intelligence and machine learning. For each technology, we identify both clinical and research recommendations. ConclusionsMany of the DDoH mechanisms encountered in medical technologies and formulae result in lower accuracy or lower validity when applied to patients outside the initial scope of development or validation. Our clinical recommendations caution clinical users in completely trusting result validity and suggest correlating with other measurement modalities robust to the DDoH mechanism (e.g., arterial blood gas for pulse oximetry, core temperatures for NCIT). Our research recommendations suggest not only increasing diversity in development and validation, but also awareness in the modalities of diversity required (e.g., skin pigmentation for pulse oximetry but skin pigmentation and sex/hormonal variation for NCIT). By increasing diversity that better reflects patients in all scenarios of use, we can mitigate DDoH mechanisms and increase trust and validity in clinical practice and research. 

Meditation, a mental and physical exercise which helps to focus attention and reduce stress has gained more popularity in recent years. However, meditation requires a concerted effort and regular practice. To explore the feasibility of using Augmented Reality (AR) Devices to assist in meditating, we recruited ten subjects to perform a five-minute meditation task integrated into AR devices. Heart Rate, Heart Rate Variability, and skin conductance response (SCR) are analyzed based on an Electrocardiogram (ECG), Electrodermal activity to monitor the physiological changes during and after a meditation session. Additionally, participants filled out surveys containing the Perceived Stress Questionnaire (PSQ), a clinically validated survey designed to evaluate stress levels before and after meditation to analyze the change in stress levels. Finally, we found significant differences in Heart Rate and Mean SCR Recovery Time for participants between the three study procedure periods (before, during, and after guided meditation).