AI-Powered Thermography for Diabetic Foot Risk Stratification: Multicenter Cross-Sectional Study
Notice bibliographique
Résumé
BACKGROUND: Diabetic foot complications are among the most severe and costly outcomes associated with diabetes, with high prevalence particularly in the Middle East and North Africa region. Current screening tools are often limited by subjectivity, invasiveness, or scalability challenges, underscoring the need for innovative approaches. OBJECTIVE: This multicenter study aimed to evaluate the performance of an artificial intelligence (AI)-powered thermographic system, Thermal Foot Scan (TFScan), in identifying patients at elevated risk of diabetic foot complications through noninvasive temperature profiling. METHODS: A multicenter cross-sectional analysis of deidentified routine screening data across 4 regions in Saudi Arabia was conducted enrolling 1120 individuals with diabetes. Participants underwent thermal imaging using a smartphone-compatible infrared camera with AI algorithms analyzing angiosomal temperature patterns and asymmetries. Risk was stratified into 4 categories (very low, low, moderate, and high). Associations between TFScan classifications and clinical risk factors, symptoms of neuropathy, and thermal abnormalities were assessed. RESULTS: While 90.7% (1016/1120) of the participants were classified as very low or low risk, 9.3% (104/1120) were identified as moderate or high risk. This higher-risk group exhibited significantly greater prevalence of key diabetic complications (P<.001). Peripheral artery disease was present in 20.2% (21/104) of moderate- and high-risk participants compared to just 0.8% (8/1016) of lower-risk individuals. Cardiovascular disease (60/104, 57.7% vs 313/1016, 30.8%), neuropathy (12/104, 11.5% vs 37/1016, 3.6%), foot deformities (15/104, 14.4% vs 6/1016, 0.6%), and symptoms of loss of protective sensation (53/104, 51% vs 354/1016, 34.8%) were all significantly more frequent in the high-risk subgroup than in the low-risk group, respectively. Thermal imaging further revealed pronounced abnormalities: temperature asymmetries of ≥2.2 °C were observed in 7.1% (79/1120) of the patients overall, with the highest asymmetry and thermal change index scores concentrated in the moderate- and high-risk groups. These individuals also exhibited greater deviations in angiosomal temperature differences-exceeding 2.2 °C in key vascular territories such as the medial plantar and lateral plantar arteries-suggesting both early inflammatory states and critical perfusion deficits. CONCLUSIONS: The TFScan system effectively stratified patients with diabetes into clinically meaningful risk categories, with moderate- and high-risk groups exhibiting a significantly higher burden of vascular, neuropathic, and thermal abnormalities. However, the cross-sectional design, partial reliance on self-report, and low prevalence of advanced complications may limit causal inference. These findings highlight the potential of AI-enhanced thermography to serve as a scalable, objective screening tool for proactive diabetic foot management. Further longitudinal studies are warranted to validate its predictive power and support widespread clinical adoption.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».