Article

Telemedical home-monitoring of diabetic foot disease using photographic foot imaging - a feasibility study

Department of Surgery, Ziekenhuisgroep Twente, location Almelo, Zilvermeeuw 1, 7600 SZ Almelo, The Netherlands.
Journal of Telemedicine and Telecare (Impact Factor: 1.54). 11/2011; 18(1):32-6. DOI: 10.1258/jtt.2011.110504
Source: PubMed

ABSTRACT

We assessed the feasibility of using a photographic foot imaging device (PFID) as a tele-monitoring tool in the home environment of patients with diabetes who were at high risk of ulceration. Images of the plantar foot were taken three times a week over a period of four months in the home of 22 high-risk patients. The images were remotely assessed by a diabetic foot specialist. At the end of the study, 12% of images were missing, mainly due to modem or server failures (66%), or non-adherence (11%). All three referrals for diagnosed ulcers and 31 of 32 referrals for abundant callus resulted in treatment. Health-related quality of life (EQ-5D visual analogue scale), increased from 7.5 at baseline to 7.9 at end of follow-up, but not significantly. Mean scores on a visual analogue scale for different usability domains (independence, ease of use, technical aspects and value) ranged from seven to nine. The study demonstrates the feasibility of using the PFID for the early diagnosis of foot disease, which may prevent complications in high-risk patients with diabetes.

1 Follower
 · 
19 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim of this pilot study was to evaluate the feasibility and explore the patients' acceptance of the -telecare model. The objective of this trial was to investigate the effects of a telecare system on elderly management at home. In a 24-months prospective study we enrolled all patients aged >65 years at risk of disability. During the two years of observation, each patient contact the TELECARE system. Telephone contact was followed by specific intervention and administration of a questionnaire evaluation. Over the 24 months we recorded 90,000 calls and 13,000 elderly were included in the telecare project. We analyzed the calls and the measures adopted. Our findings provide evidence of improved quality of life through clinical management at home from a telecare system. The use of this system had high adherence and was feasible for elderly patients and their family.
    No preview · Article · Oct 2012 · Recenti progressi in medicina
  • [Show abstract] [Hide abstract]
    ABSTRACT: Early detection of (pre-)signs of ulceration on a diabetic foot is valuable for clinical practice. Hyperspectral imaging is a promising technique for detection and classification of such (pre-)signs. However, the number of the spectral bands should be limited to avoid overfitting, which is critical for pixel classification with hyperspectral image data. The goal was to design a detector/classifier based on spectral imaging (SI) with a small number of optical bandpass filters. The performance and stability of the design were also investigated. The selection of the bandpass filters boils down to a feature selection problem. A dataset was built, containing reflectance spectra of 227 skin spots from 64 patients, measured with a spectrometer. Each skin spot was annotated manually by clinicians as "healthy" or a specific (pre-)sign of ulceration. Statistical analysis on the data set showed the number of required filters is between 3 and 7, depending on additional constraints on the filter set. The stability analysis revealed that shot noise was the most critical factor affecting the classification performance. It indicated that this impact could be avoided in future SI systems with a camera sensor whose saturation level is higher than 106, or by postimage processing.
    No preview · Article · Dec 2013 · Journal of Biomedical Optics
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this study security aspects are considered for the protection of medical information in patient telemonitoring schemes. In order to propose mechanisms to efficiently protect clinical information, it is presented a case study of a wireless network telemonitoring scheme, the results of a risk assessment to detect security problems in this type of schemes are analyzed.
    No preview · Chapter · Jan 2014
Show more