Artificial Intelligence-Assisted Clinical Decision Support System in Telemedical Wound Care: A Randomized Controlled...

Chronic wounds are increasingly prevalent due to an aging population and rising chronic diseases. Effective wound care is often hindered by the inexperience of home caregivers, leading to suboptimal healing outcomes. Telemedicine has emerged as a solution to bridge care gaps, though manual wound assessment remains a significant burden. Artificial intelligence (AI) presents an opportunity to enhance wound evaluation and management.

To assess the effectiveness of an AI-assisted clinical decision support system integrated into a telemedicine platform, "Ulcer Care" (UC), in the management of chronic wounds, and to evaluate its impact on the psychosocial outcomes of both patients and caregivers.

A randomized controlled trial was conducted between July 2023 and February 2024, involving 40 patients with chronic ulcers who were randomly assigned to either the UC group (AI-assisted telemedical care) or the control group (conventional care). The UC system utilized AI to automatically measure wound size, classify tissue types, and issue alerts for deteriorating wounds with doctors' feedback. The primary endpoint was wound healing at 12 weeks, assessed by percentage reduction in wound area and healing status. Secondary endpoints included patient and caregiver quality of life (PU-QOL and FDLQI), clinical visits, and complications.

Thirty-five patients completed the study (17 in the UC group, 18 in the control group). The wound healing rates and percentage reduction in wound area were similar between the groups (64.9% vs 73.4%, P = 0.88), but the UC group required significantly fewer clinic visits (5.5 ± 2.6 vs 13.2 ± 10.6, P = 0.009). Both groups showed improvements in quality of life, with the UC group demonstrating a greater improvement in caregiver quality of life (FDLQI improvement: 10.3 ± 5.0 vs 5.7 ± 5.9, P = 0.08).

The AI-assisted telemedicine platform "Ulcer Care" was found to be noninferior to conventional wound care in terms of wound healing outcomes and significantly improved caregiver quality of life. While the system demonstrated potential for improving chronic wound management, further development of AI accuracy and system usability is needed. This study highlights the utility of AI in telemedicine as an adjunct to chronic wound care, offering potential benefits in reducing healthcare utilization and enhancing patient outcomes.