A collaborative project between the University of Melbourne and RMIT has developed a thermal imaging artificial intelligence (AI) tool called THERMUL to prevent diabetes related foot ulcer hospitalisations and amputations by improving early intervention rates.
Diabetes affects over 500 million people globally and up to 34 per cent of people with the condition will develop a foot ulcer during their lifetime. Diabetes-related foot ulcers can lead to infection, hospitalisation, lower limb amputation and early death if not managed appropriately.
The key outcome of the collaboration is a smartphone-based tool that uses thermal imaging and AI to predict whether a diabetes related foot ulcer is likely to heal within 12 weeks. The technology analyses patterns within thermal images of wounds that may indicate whether an ulcer is healing as expected or is at risk of delayed healing.
Researchers at the University of Melbourne, RMIT University and Bolton Clarke conducted a clinical study at Austin Health and St Vincent's hospital Melbourne involving 110 patients with diabetes related foot ulcers.
Using a light-weight thermal camera, researchers took images of the patients' ulcers when they initially presented to the clinic, with additional images captured two and four weeks later.
At twelve weeks, clinicians assessed whether each ulcer had healed, allowing the research team to compare healing outcomes with the thermal image data collected earlier.
Endocrinologist Professor Elif Ekinci, Head of the University of Melbourne's Department of Medicine and Director of the Australian Centre for Accelerating Diabetes Innovations (ACADI), said: "Using this data, we trained an AI algorithm to recognise heat patterns within the initial thermal images that were associated with ulcers that went on to heal, compared with those that did not."
"These patterns may provide an early indication of a wound's likely healing trajectory, potentially allowing clinicians to identify people who might benefit from earlier intervention or escalation of care."
RMIT University Professor Dinesh Kumar said the technology has the potential to improve health equity and deliver economic benefits for Australia's healthcare system.
"Diabetes-related foot disease places a significant burden on individuals and the Australian health system, costing an estimated $875 million every year," he said.
"By enabling earlier identification of ulcers at risk of delayed wound healing, THERMUL has the potential to improve access to timely care and reduce complications associated with diabetes related foot disease."
Current clinical guidelines often assess healing progress over the first four weeks of treatment to determine whether a diabetes related foot ulcer is healing as expected.
However, regular access to specialist support can be difficult for many people living in regional, rural and remote communities.
Senior research fellow at Bolton Clarke, Dr Rajna Ogrin, said: "People in regional areas who are living with diabetes and receive care at home, or through outreach services, may not have timely access to specialist diabetes foot services."
"A portable, non-contact tool like THERMUL has the potential to bring specialist-level decision support closer to where people live and receive care."
This project initially received seed funding from ACADI, which enabled the research team to develop the project to the prototype stage.
The research team recently secured $490,539 in grant funding through Australia's Economic Accelerator program and $50,000 from the University of Melbourne's Proof of Concept Fund to expand validation of the technology across a wider range of healthcare settings, including metropolitan, regional and remote services, and to further improve the predictive model using data from more diverse population groups.
THERMUL is currently progressing through additional validation and development activities required to support future translation into clinical practice.
Partner organisations include the Australian Centre for Accelerating Diabetes Innovations, Austin Health, Bolton Clarke, St Vincent's Hospital Melbourne, Royal Flying Doctor Service Victoria and Software Medical Devices Pty Ltd.
