New technological advance of Spanish seal that facilitates early diagnosis and quality of care for patients with diabetic foot. It is a application based on the Artificial Intelligence (AI) and in the thermographic imaging, capable of detecting the risk of diabetic neuropathy and peripheral arterial disease, pathologies associated with diabetic foot ulcers that, in many cases, end in amputation. The tool is currently in the development phase and hopes to access Primary Care in the near future.
The project was born as a result of a collaboration between the start-up Clinicgram and the Complutense Universityfrom Madrid (UCM)through an agreement by which the professor’s research team José Luis Lázaro-Martínez, head of the Diabetic Foot Unit at the UCM, has been able to develop the AI algorithm with which the app works. To know how the tool works and its applications, HealthDigital has interviewed the professor, main author of the project along with the teachers Irene Sanz Corbalan and Aroa Tardáguila García.
Originally, the application was designed solely to collect data and obtain images of patients with chronic wounds of different etiologies. When the professor’s team entered the project, a little over two years ago, which It was originally conceived as a database app, became a project that could shed light on the early diagnosis of patients with diabetic foot. After several considerations, finally “an artificial intelligence algorithm and a thermographic camera were included that allow obtaining a diagnostic approach for patients with diabetic foot.”
He algorithm of AI with which the application “collects general patient datathat is, your disease, comorbidities, complications associated with diabetes, and also foot thermography data”. This thermography performs stratification by different parameters: by zones, by anatomical regions, by peripheral and central zones, etc. “Subsequently, it takes the values that have been fed by this artificial intelligence, the diagnosis of neuropathy (sensitivity tests) and the diagnosis of the patient’s vascular status at a macro and microvascular level.”
The diabetic neuropathy and Peripheral arterial disease They are the two pathologies associated with diabetic foot ulcers. Neuropathy affects the nerve and loss of sensitivity, a risk for the patient since they can suffer trauma and injuries without being aware of it. On the other hand, peripheral arterial disease is a process of atherosclerosis by which an atheromatous plaque forms inside an artery, thus causing an occlusion of the blood vessel. Consequently, less blood reaches the foot, affecting wound healing time. “The most common thing is that the diabetic foot patient suffers from both neuropathies,” recalls José Luis Lázaro, and “patients with poor vascularization can end up in amputation.”
“With the tool we seek primary prevention by detecting these patients as soon as possible to transform their behaviors into healthy habits, such as correcting the type of footwear or primary care,” indicates the professor. In this way, they can minimize the risk of traumatic events in the foot, since “the average healing time for a wound is around 3 months, although some injuries may take between one and two years to heal. The expert highlights the strong impact on quality of life of patients with diabetic foot and remember that many studies link this disease with depression, precisely due to the limitation in mobility and its psychosocial aspect.
USE OF THE DEVICE
Using the Clinicgram and UCM application is a simple process, which only requires the entering patient data and of the taking the thermographic image through a mobile device. The professor points out that what may take the most time is the introduction of the patient’s medical history, such as the date from which he was diagnosed with diabetes, possible hypertension, if he takes any type of medication, etc. However, it is relatively easy, since it is offered in the form of dropdowns. Finally, the thermographic image is taken with a camera adapted to a smartphone. In matter of 5 minutesthe app will offer its approximation.
The new application allows a probability recommendation whether the patient has peripheral arterial disease (ischemia), neuropathy, or both. In this way, “it is possible to reduce what normally takes an hour and a half in a consultation by performing the tests at just 5 minutes thanks to taking images.” The professor explains that it is “a support tool for health personnel” since, due to regulatory issues, “it cannot directly offer a diagnosis.” In any case, it helps to carry out a “first screening” that guides in the identification of those patients who do need confirmatory diagnostic tests.
EARLY DIAGNOSIS AND REDUCTION OF HEALTH COST
José Luis Lázaro remembers that in Spain there are about 6 and a half million people with diabetes, an extremely high figure that complicates diagnoses and quality of care. In this challenge, the new AI application “facilitates primary screening” and has strong potential for Primary Care. Although it is currently in the validation phase, “it is already being tested in different centers in Spain” and hopes to have its own place in the first level of care: “We are trying to see the interest on the part of public administrations to implement it at different levels assistance, but our focus fundamentally is Primary Care”.
“A greater investment in prevention and Primary Care can avoid traumatic events, especially in a society that is increasingly living longer”
Thanks to its ease of use and the agility of its recommendations, the AI tool allows save time, “a permanent demand, especially from Primary Care professionals.” It also “allows us to reduce the normal cost of an examination in 55 minutes and, in addition, it avoids the event of producing a wound, which can mean an average health saving of 50,000 euros.” It is estimated that in Spain there are one million people with diabetic foot ulcersso treating these patients with this screening tool can save millions in healthcare costs.
Finally, the expert wants to remember the importance of reinforce awareness about the diabetic foot in society and in people with diabetes, because “this complication is largely unknown, despite that is preventable”. He adds that “greater investment in prevention and Primary Care can avoid traumatic events, especially in a society that is increasingly living longer, but at the expense of greater complications.”