Validation of low-cost smartphone-based thermal camera for diabetic foot assessment

R. F.M. van Doremalen* (Corresponding Author), J. J. van Netten, J. G. van Baal, M. M.R. Vollenbroek-Hutten, F. van der Heijden

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    29 Citations (Scopus)
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    Aims: Infrared thermal imaging (IR) is not yet routinely implemented for early detection of diabetic foot ulcers (DFU), despite proven clinical effectiveness. Low-cost, smartphone-based IR-cameras are now available and may lower the threshold for implementation, but the quality of these cameras is unknown. We aim to validate a smartphone-based IR-camera against a high-end IR-camera for diabetic foot assessment. Methods: We acquired plantar IR images of feet of 32 participants with a current or recently healed DFU with the smartphone-based FLIR-One and the high-end FLIR-SC305. Contralateral temperature differences of the entire plantar foot and nine pre-specified regions were compared for validation. Intra-class correlations coefficient (ICC(3,1)) and Bland-Altman plots were used to test agreement. Clinical validity was assessed by calculating statistical measures of diagnostic performance. Results: Almost perfect agreement was found for temperature measurements in both the entire plantar foot and the combined pre-specified regions, respectively, with ICC values of 0.987 and 0.981, Bland-Altman plots’ mean Δ = −0.14 and Δ = −0.06. Diagnostic accuracy showed 94% and 93% sensitivity, and 86% and 91% specificity. Conclusions: The smartphone-based IR-camera shows excellent validity for diabetic foot assessment.

    Original languageEnglish
    Pages (from-to)132-139
    Number of pages8
    JournalDiabetes Research and Clinical Practice
    Early online date6 Feb 2019
    Publication statusPublished - 1 Mar 2019


    • Diabetes mellitus
    • Diabetic foot
    • Foot ulcer
    • Smartphone
    • Temperature
    • Thermal infrared


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