Prediction of amputation risk of patients with diabetic foot using classification algorithms: A clinical study from a tertiary center

Denizhan Demirkol*, Çiğdem Selçukcan Erol, Xavier Tannier, Tuncay Özcan, Şamil Aktaş

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Diabetic foot ulcers can have vital consequences, such as amputation for patients. The primary purpose of this study is to predict the amputation risk of diabetic foot patients using machine-learning classification algorithms. In this research, 407 patients treated with the diagnosis of diabetic foot between January 2009–September 2019 in Istanbul University Faculty of Medicine in the Department of Undersea and Hyperbaric Medicine were retrospectively evaluated. Principal Component Analysis (PCA) was used to identify the key features associated with the amputation risk in diabetic foot patients within the dataset. Thus, various prediction/classification models were created to predict the “overall” risk of diabetic foot patients. Predictive machine-learning models were created using various algorithms. Additionally to optimize the hyperparameters of the Random Forest Algorithm (RF), experimental use of Bayesian Optimization (BO) has been employed. The sub-dimension data set comprising categorical and numerical values was subjected to a feature selection procedure. Among all the algorithms tested under the defined experimental conditions, the BO-optimized “RF” based on the hybrid approach (PCA-RF-BO) and “Logistic Regression” algorithms demonstrated superior performance with 85% and 90% test accuracies, respectively. In conclusion, our findings would serve as an essential benchmark, offering valuable guidance in reducing such hazards.

Original languageEnglish
Article numbere14556
JournalInternational Wound Journal
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Funding

This research is produced from the first author's doctoral thesis, which has been entitled “Prediction of Amputation Risk of Patients with Diabetic Foot by Artificial Intelligence Techniques,” supervised by Assoc. Prof. Çiğdem EROL (Ph.D.) from İstanbul University, Institute of Science. This thesis research program is also funded by The Scientific and Technological Research Council of Turkey (TÜBİTAK) 2214‐A‐International Research Fellowship Programme for Ph.D. Students and French Government Research Fellowships in Turkey, organized by Campus France Paris. Thus, joint research activities carried out with Professor Xavier TANNIER (Ph.D.) from Sorbonne Université/INSERM/Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances en e‐Santé (LIMICS). We would like to thank all the personnel who made this research possible, working between March 2019 and March 2020 in the Department of Underwater and Hyperbaric Medicine at Istanbul University, Istanbul Faculty of Medicine. We especially profoundly thank specialist Dr. Özdinç Acarlı (M.D.) for his support in the process of data collection and DFUs classification. Moreover, we would like to give our special thanks to The Scientific and Technological Research Council of Turkey (TÜBİTAK) for granting this thesis research program. In addition, we would like to thank Professor Sevinç GÜLSEÇEN (Ph.D.), the Head of the Istanbul University Department of Informatics, for her understanding and support during this research. We express our sincere appreciation to Campus France for their invaluable assistance, which has been instrumental in advancing our research. Last but not least, we also would like to thank Director Professor Marie-Christine JAULENT(Ph.D.) from Sorbonne Université/INSERM/Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances en e-Santé (LIMICS) for her generous support during the research process in Paris-France.

FundersFunder number
Istanbul Faculty of Medicine
Istanbul University Department of Informatics
Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances en e-Santé
Institut national de la santé et de la recherche médicale
Istanbul Üniversitesi
Türkiye Bilimsel ve Teknolojik Araştırma Kurumu
Sorbonne Université

    Keywords

    • amputation
    • artificial intelligence
    • classification
    • diabetic foot
    • machine learning

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