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Published on: September 8, 2023
Validation of low-cost smartphone-based thermal camera for diabetic foot assessment
R F M van Doremalen1, J J van Netten2, J G van Baal3
1University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands; Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609 PP Almelo, the Netherlands.
Aims:
Infrared thermal imaging (IR) is not yet routinely implemented for early detection of diabetic foot ulcers (DFU), despite proven clinical effectiveness. Low-cost, smartphone-based IR-cameras are now available and may lower the threshold for implementation, but the quality of these cameras is unknown. We aim to validate a smartphone-based IR-camera against a high-end IR-camera for diabetic foot assessment.
Methods:
We acquired plantar IR images of feet of 32 participants with a current or recently healed DFU with the smartphone-based FLIR-One and the high-end FLIR-SC305. Contralateral temperature differences of the entire plantar foot and nine pre-specified regions were compared for validation. Intra-class correlations coefficient (ICC(3,1)) and Bland-Altman plots were used to test agreement. Clinical validity was assessed by calculating statistical measures of diagnostic performance.
Results:
Almost perfect agreement was found for temperature measurements in both the entire plantar foot and the combined pre-specified regions, respectively, with ICC values of 0.987 and 0.981, Bland-Altman plots' mean Δ = -0.14 and Δ = -0.06. Diagnostic accuracy showed 94% and 93% sensitivity, and 86% and 91% specificity.
Conclusions:
The smartphone-based IR-camera shows excellent validity for diabetic foot assessment.
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