University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands; Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609 PP Almelo, the Netherlands.
Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609 PP Almelo, the Netherlands; School of Clinical Sciences, Queensland University of Technology, 2 George St, Brisbane City, QLD 4000, Australia.
Diabetes Res Clin Pract. 2019 Mar;149:132-139. doi: 10.1016/j.diabres.2019.01.032. Epub 2019 Feb 6.
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.
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.
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.
The smartphone-based IR-camera shows excellent validity for diabetic foot assessment.
尽管红外热成像（IR）在糖尿病足溃疡（DFU）的早期检测中已被证实具有临床有效性，但尚未常规实施。现在，有价格低廉的基于智能手机的 IR 摄像机，这可能会降低实施的门槛，但这些摄像机的质量尚不清楚。我们旨在验证一种基于智能手机的 IR 相机与高端 IR 相机在糖尿病足评估中的性能。
我们使用基于智能手机的 FLIR-One 和高端 FLIR-SC305 对 32 名患有当前或近期愈合的 DFU 的参与者的足底进行了 IR 图像采集。比较了整个足底和九个预先指定区域的对侧温差，以进行验证。使用组内相关系数（ICC(3,1)）和 Bland-Altman 图来测试一致性。通过计算诊断性能的统计指标来评估临床有效性。
在整个足底和组合的预先指定区域的温度测量中，都发现了几乎完美的一致性，ICC 值分别为 0.987 和 0.981，Bland-Altman 图的平均 Δ = -0.14 和 Δ = -0.06。诊断准确性显示出 94%和 93%的敏感性，以及 86%和 91%的特异性。
基于智能手机的 IR 相机在糖尿病足评估中具有出色的有效性。
