Assessment of foot disease in the home environment of diabetic patients using a new photographic foot imaging device

Abstract

The objective of this study was to compare live and photographic assessments of clinical signs of diabetic foot disease using a new photographic foot imaging device. High quality colour photographs of the plantar foot surface were collected in 20 diabetic feet using a prototype device and in 19 diabetic feet using a definitive version of the device with optimized illumination settings. All photographs were assessed independently by four observers for presence of ulceration, abundant callus, or absence of signs and compared with live and repeated photographic assessments of the feet by the same observers. Agreement between assessments was moderate to good for all outcomes using the prototype device (56-92%) and improved using the definitive version of the device (74-100%). The data seem to suggest that important signs of diabetic foot disease can be diagnosed from high quality photographs using the photographic foot imaging device. Intended for use as telemedical monitoring device in the patients' home, frequent remote assessments may potentially contribute to the early recognition and treatment of foot disease, which may prevent further complications.

Telehealth and telemedicine applications for the diabetic foot: A systematic review

“…Bus et al showed that with using a photographic foot imaging device intended for home use, a good agreement between live and photographic assessment (>74%) and between repeated photographic assessments (>82%) could be obtained for assessing the presence of abundant callus, ulceration and for the absence of signs . This was further elaborated on by Hazenberg et al who showed good agreement between assessment from photographs and live assessment for the presence of ulcers ( k = 0.87) and for absence of any sign ( k = 0.83), and moderate agreement for the presence of abundant callus ( k = 0.61) .…”

“…57 58 Bus et al showed that with using a photographic foot imaging device intended for home use, a good agreement between live and photographic assessment (>74%) and between repeated photographic assessments (>82%) could be obtained for assessing the presence of abundant callus, ulceration and for the absence of signs. 59 This was T A B L E 2 Assessment of risk of bias in the included (non)randomized controlled trials 60 Outcomes were also reliable between repeated photographic assessments (k = 0.70-1.00). 60 Good feasibility of using the photographic foot imaging device in the home environment was also shown: patient adherence was high, referrals based on photographic assessment justified, and perceived usability was good.…”

“…Type of Approach/Technology Dermal thermography Infrared 19 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]37 Thermistor 2 35,36 Liquid-crystal 3 [38][39][40] Hyperspectral imaging 11 [41][42][43][44][45][46][47][48][49][50][51] Photographic imaging 13 [52][53][54][55][56][57][58][59][60][61][63][64][65] Dermal thermography + photographic imaging 1 62 Audio/video/online communication 12 [66][67]…”

Risk Factors of Methicillin-Resistant Staphylococcus Aureus and Pseudomonas Infection in Diabetic Foot Ulcers in Korea

“…Unfortunately, even when specialist consultation is available, clinicians often do not make timely referrals to a multidisciplinary diabetic foot care team [70]. Because providers in some communities may not have ready access to specialists, they may consider consultation via electronic or telephonic arrangements (sometimes referred to as telemedicine) [71,72]. Although using high-resolution optical equipment may be optimal [73], even standard or video telephones have allowed expert consultation from a distance [74].…”

An intelligent telemedicine system for detection of diabetic foot complications

“…The predecessor of this study, Vincent 50 [30][31][32], showed that some of the important pre-signs of ulceration, such as blister and redness, can hardly be diagnosed using digital photography only. Besides, complimentary preliminary research [37,38] noticed that changes of the appearance of a risk area based on digital photography does not automatically imply the beginning of an ulcer.…”