Spinazzola Elisabetta, Picaud Guillaume, Becchi Sara, Pittarello Monica, Ricci Elia, Chaumont Marc, Subsol Gérard, Pareschi Fabio, Teot Luc, Secco Jacopo
Department of Electronics and Telecommunications, Politecnico di Torino, 10123 Turin, Italy.
LIRMM, ICAR Team, University Montpellier, CNRS, 34000 Montpellier, France.
J Clin Med. 2025 Apr 24;14(9):2943. doi: 10.3390/jcm14092943.
Chronic diabetic foot ulcers are a global health challenge, affecting approximately 18.6 million individuals each year. The timely and accurate prediction of wound healing paths is crucial for improving treatment outcomes and reducing complications. In this study, we apply predictive modeling to the case study of diabetic foot ulcers, analyzing and comparing multiple models based on Deep Neural Networks (DNNs) and Machine Learning (ML) algorithms to enhance wound prognosis and clinical decision making. Our approach leverages a dataset of 1766 diabetic foot wounds, each monitored for at least three visits, incorporating key clinical wound features such as WBP scores, wound area, depth, and tissue status. Among the 12 models evaluated, the highest accuracy (80%) was achieved using a three-layer LSTM recurrent DNN trained on wound instances with four visits. The model performance was assessed through AUC (0.85), recall (0.80), precision (0.79), and F1-score (0.80). Our findings indicate that the wound depth and area at the first visit followed by the wound area and granulated tissue percentage at the second visit are the most influential factors in predicting the wound status. As future developments, we started building a weakly supervised semantic segmentation model that classifies wound tissues into necrosis, slough, and granulation, using tissue color proportions to further improve model performance. This research underscores the potential of predictive modeling in chronic wound management, specifically in the case of diabetic foot ulcers, offering a tool that can be seamlessly integrated into routine clinical practice.
慢性糖尿病足溃疡是一项全球性的健康挑战,每年影响约1860万人。及时、准确地预测伤口愈合路径对于改善治疗效果和减少并发症至关重要。在本研究中,我们将预测建模应用于糖尿病足溃疡的案例研究,分析和比较基于深度神经网络(DNN)和机器学习(ML)算法的多种模型,以改善伤口预后和临床决策。我们的方法利用了一个包含1766例糖尿病足伤口的数据集,每个伤口至少监测三次,纳入了关键的临床伤口特征,如WBP评分、伤口面积、深度和组织状态。在评估的12种模型中,使用在四次就诊的伤口实例上训练的三层LSTM循环DNN实现了最高准确率(80%)。通过AUC(0.85)、召回率(0.80)、精确率(0.79)和F1分数(0.80)评估模型性能。我们的研究结果表明,首次就诊时的伤口深度和面积,其次是第二次就诊时的伤口面积和肉芽组织百分比,是预测伤口状态的最有影响因素。作为未来的发展方向,我们开始构建一个弱监督语义分割模型,该模型使用组织颜色比例将伤口组织分为坏死、腐肉和肉芽组织,以进一步提高模型性能。本研究强调了预测建模在慢性伤口管理中的潜力,特别是在糖尿病足溃疡的情况下,提供了一种可以无缝集成到常规临床实践中的工具。