Assessment of foot disease in the home environment of diabetic patients using a new photographic foot imaging device

Abstract

The objective of this study was to compare live and photographic assessments of clinical signs of diabetic foot disease using a new photographic foot imaging device. High quality colour photographs of the plantar foot surface were collected in 20 diabetic feet using a prototype device and in 19 diabetic feet using a definitive version of the device with optimized illumination settings. All photographs were assessed independently by four observers for presence of ulceration, abundant callus, or absence of signs and compared with live and repeated photographic assessments of the feet by the same observers. Agreement between assessments was moderate to good for all outcomes using the prototype device (56–92%) and improved using the definitive version of the device (74–100%). The data seem to suggest that important signs of diabetic foot disease can be diagnosed from high quality photographs using the photographic foot imaging device. Intended for use as telemedical monitoring device in the patients' home, frequent remote assessments may potentially contribute to the early recognition and treatment of foot disease, which may prevent further complications.

Keywords:

• Diabetic foot
• Ulcer
• Digital photography
• Remote assessment
• Telemedicine
• Prevention

Acknowledgements

The authors gratefully acknowledge the contribution of Adriaan Bril and Erik Manning in live and photographic assessments of the diabetic feet, and Anke Kottink for her help in collecting data for the study. This study was supported by a grant within the Euregio Interreg IIIA program (project nr. 2-EUR-II-2-82).