The evolving field of mobile applications : a smarter approach to diabetic foot ulcer measurement

Abstract

Aim: This study evaluates the inter-rater reliability of diabetic foot ulcer (DFU) measurement using the traditional paper-ruler method versus the Imito Wound Application. Given the clinical importance of accurate and reproducible ulcer measurement, the research aims to determine whether a smartphone-based application offers a more reliable alternative to standard care, thereby improving DFU prognosis and management. Research Design and Method: A comparative observational study was conducted involving clinicians measuring DFUs using both the paper-ruler method and the Imito Wound App. A total of 67 DFUs were assessed, with each ulcer measured independently by three raters using both methods. The inter-rater reliability was analyzed using intraclass correlation coefficients (ICC), and statistical assessments were performed using SPSS software. Additional analyses considered the impact of ulcer shape and location on measurement reliability. Results: The results have highlighted that measurements performed by the ruler method have a difference by 1.43 times across all raters when compared to the Imito Application results. The ICC of both measurements was very good, with Imito App having a slightly better interrater reliability that of ICC- 0.975 vs ICC of 0.970 for the Ruler measurements. Ulcer shape and location influenced reliability, with irregularly-shaped DFUs exhibiting greater measurement discrepancies in the ruler method. Conclusion: The findings underscore the limitations of the paper-ruler method and support the use of smartphone-based wound measurement tools for DFU assessment. The Imito Wound App significantly enhances measurement reliability, reducing inconsistencies that could impact treatment decisions by the introduction of a more objective measuring tool. Integrating digital wound measurement into clinical practice could improve DFU monitoring, ultimately reducing the risk of complications and lower limb amputations.