Machine learning model to classify chronic leg wounds and identify pyoderma gangrenosum
Bibliographic record
Abstract
STUDY OBJECTIVES: Chronic wounds represent a significant economic and personal burden. For their successful treatment, the causes must be known and treated. Wounds caused by pyoderma gangrenosum (PG), a rare inflammatory skin disease, are often misdiagnosed. This study, therefore, aims to develop a machine learning model capable of differentiating PG from other wound types, focusing on chronic leg wounds to address this diagnostic challenge. METHODS: We used 3674 wound photographs from three specialised wound centres with the four most common types of foot and leg ulcers and the rare inflammatory differential diagnosis PG. The convolutional neural network classifier ConvNeXt 'B' was pretrained on LAION2B, ImageNet12k and ImageNet 1k before being trained and fine-tuned on an 85:15 train, validation split. RESULTS: The model achieved an overall high accuracy in multiclass classification of the chronic wounds (unbalanced accuracy 90%, balanced accuracy 87%). The sensitivity for identifying PG was 94%, while the sensitivity forother chronic wound types was 97% for diabetic foot ulcers (DFU), 92% for venous leg ulcers (VLU), 78% for mixed leg ulcers and 74% for arterial leg ulcers. DISCUSSION: The machine learning model effectively differentiates PG from the most common leg and foot ulcers and was very accurate for classifying DFU and VLU. A higher rate of misclassifications occurred for the other vascular ulcers, that is, mixed and arterial leg ulcers. This aligns with the challenges in clinical practice. CONCLUSION: Despite the limited number of wound images, this novel multiclass wound classification model accurately identified PG and differentiated leg and foot ulcer subtypes, providing a foundation for a diagnostic support system.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".