Armstrong, Ken

Cleland, Ian

Madill, Godfrey

Nugent, Chris

Rafferty, Joseph

English

Global incidence of diabetes is rising. If notproperly managed and treated, diabetes can lead to seriouscomplications, notably amputations, due to Diabetic FootDisease (DFD). Amputations from DFD can be reduced throughmonitoring/analysis. This study evaluates a number of sensingelements to enable a novel monitoring/analysis platform for thepurposes of assessment of DFD

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? Abstract? Global incidence of diabetes is rising. If not properly managed and treated, diabetes can lead to serious complications, notably amputations, due to Diabetic Foot Disease (DFD). Amputations from DFD can be reduced through monitoring/analysis. This study evaluates a number of sensing elements to enable a novel monitoring/analysis platform for the purposes of assessment of DFD. I. INTRODUCTION AND RELATED WORK In recent years there has been a global obesity epidemic. Associated with this is an increase in the number of diagnosed cases of diabetes [1]. If diabetes is mismanaged, serious complications can occur including the need for amputation. It is estimated that globally, due to diabetes, a limb is lost every 30 seconds [1]. Informed self-management of this condition increases care reducing amputations [2]. In the case of Diabetic Foot Disease (DFD) indicative precursors to amputation include development of ulcers and reduction in blood circulation. Current works [1?3] have successfully detected these precursors using thermal information about the foot. These approaches use a number of sensing elements ranging from contact Skin Temperature Probes (STP), IR thermometers (IRT) and thermal vision camera systems [1?3].  STPs provide an accurate way to gauge foot temperature with some caveats. STPs are disposable so have a recurring cost, physical contact may encourage disease or infection and the sensors require placement on specific points on the foot to generate useful readings. Similarly, IRTs have issues related to requiring specific sampling points. Finally, use of point sampling captures limited information, reducing diagnostic potential. Thermal vision camera solutions have been used with promising results [3]. These collect high resolution temperature data about the entire foot. Current thermal camera solutions are expensive, requiring a specific controlled environment and do not incorporate automated analysis. To address these deficiencies, the authors propose the use of low cost simple thermal sensing elements used within a diagnostic solution. This approach enables low cost monitoring through the use of contactless sensors. This would increase sampling frequency, reusability and lower the barrier to data capture. This solution could additionally provide condition management in conjunction with offline, local and remote analysis.   In order to achieve this, a number of sensing elements need to first be evaluated for their suitability, as determined by accuracy and Reading Attenuation (RA). RA is important as this solution may not operate at a fixed distance, however, will  Invest Northern Ireland is acknowledged for supporting this project under the Competence Centre Programme Grant RD0513853 - Connected Health Innovation Centre. J. Rafferty, I. Cleland and C. Nugent are with Ulster University, Jordanstown, Northern Ireland, BT37 0QB, UK (e-mail: j.rafferty@ulster.ac.uk, i.cleland@ulster.ac.uk, cd.nugent@ulster.ac.uk). K. Armstrong is with the Lava Group 17 Falcon Road, Belfast, UK BT12 6RD (k.armstrong@thelavagroup.co.uk).  G. Madill is with Prosthetic Forum NI. guide alignment through a user interface. An evaluation of these sensing elements is presented in Section II.  II. EVALUATION OF THERMAL SENSING ELEMENTS A number of sensing elements have been evaluated to compare accuracy in relation to medical grade contact sensor and an IR sensor, as used in current DFD analysis. The sensing elements tested are cost effective, reusable, contactless and may operate with the solution to enable production of this management platform. Sensors evaluated were a Texas Intruments SensorTag, a FLIR ONE, a Heimann HTPA, a Seek and an IRT. All these devices, except the IRT, can be easily integrated into a diagnostic solution. SensorTags are small modules that can sample emissive temperature through use of a directional IR thermopile. The FLIR One and Seek are consumer-grade thermal vision cameras. The HTPA is an industrial-grade thermal vision sensor. The IRT is akin to those used in DFD detection. These sensors were tested against the ground truth data provided by the STP (Philips, 21091A). Table I presents the results of this comparison, throughout a range of distances.  TABLE I.  A COMPARISON OF THE ACCURACY OF A NUMBER OF THERMAL SENSING ELEMENTS AT A RANGE OF DISTANCES  In evaluating these sensors, two factors will be considered, deviation and RA. Deviation of readings should remain within the range set by the STP and IRT as these are two accepted sensing elements for this application. Only the FLIR one meets this criterion. RA is determined by evaluating the range of temperatures from the 1cm and 45cm readings. Elements that express better RA than the IRT will be considered, these are FLIR one and the HTPA.  Through this evaluation it is apparent that the FLIR one should be adopted for a DFD analysis platform due to it having the higher accuracy and less attenuation than all other evaluated contactless sensing elements.  REFERENCES 1. International Diabetes Federation: IDF Diabetes Atlas Sixth Edition. (2013). 2. Ellis, P., Senior, C.: Diabetes education: the big missed opportunity in diabetes care. Dibetes UK (2015). 3. Liu, C., van Netten, J.J., Baal, J.G. Van, Bus, S.A., van Der Heijden, F.: Automatic detection of diabetic foot complications with infrared thermography by asymmetric analysis. J. Biomed. Opt. 20, -?026003 (2015). An evaluation of contactless thermal sensing elements for use in a technology based diabetic foot disease detection solution Joseph Rafferty, Ian Cleland, Chris Nugent, Ken Armstrong, Godfrey Madill Sensor Negative deviation (c) at sensing element distance (cm) 1 Cm 5 cm 10 cm 15 cm 20 cm 25 cm 30 cm 35 cm 40 cm 45 cm Sensor Tag 13.4c 16.12c 17.58c 17.37c 17.37c 16.67c 18.17c 18.07c 18.28c 18.5c FLIR One 4.0c 5.1c 5.29c 4.5c 4.79c 5.07c 5.74c 5.47c 5.37c 5.58c SEEK 7.31c 9.50c 8.31c 8.59c 8.68c 9.50c 9.22c 10.13c 10.40c 11.31c HTPA 8.86c 9.09c 8.91c 9.10c 9.10c 9.32c 10.27c 10.28c 10.47c 10.86c IRT 7.31c 7.59c 7.68c 7.40c 7.97c 8.46c 9.04c 9.15c 9.08c 9.26c 

An evaluation of contactless thermal sensing elements for use in atechnology based diabetic foot disease detection solution

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An evaluation of contactless thermal sensing elements for use in atechnology based diabetic foot disease detection solution

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