Wound imaging software and digital platform to assist review of surgical wounds using patient smartphones: The development and evaluation of artificial intelligence (WISDOM AI study)

作者：Melissa Rochon, Judith Tanner, James Jurkiewicz, Jacqueline Beckhelling, Akuha Aondoakaa, Keith Wilson, Luxmi Dhoonmoon, Max Underwood, L. H. Mason, Roy Harris, Karen Cariaga · 发表于：PLoS ONE · 年份：2024 · DOI：10.1371/journal.pone.0315384 · 被引用次数：16 · 研究领域：Pressure Ulcer Prevention and Management、Surgical site infection prevention、Surgical Sutures and Adhesives

INTRODUCTION: Surgical patients frequently experience post-operative complications at home. Digital remote monitoring of surgical wounds via image-based systems has emerged as a promising solution for early detection and intervention. However, the increased clinician workload from reviewing patient-submitted images presents a challenge. This study utilises artificial intelligence (AI) to prioritise surgical wound images for clinician review, aiming to efficiently manage workload. METHODS AND ANALYSIS: Conducted from September 2023 to March 2024, the study phases included compiling a training dataset of 37,974 images, creating a testing set of 3,634 images, developing an AI algorithm using 'You Only Look Once' models, and conducting prospective tests compared against clinical nurse specialists' evaluations. The primary objective was to validate the AI's sensitivity in prioritising wound reviews, alongside assessing intra-rater reliability. Secondary objectives focused on specificity, positive predictive value (PPV), and negative predictive value (NPV) for various wound features. RESULTS: The AI demonstrated a sensitivity of 89%, exceeding the target of 85% and proving effective in identifying cases requiring priority review. Intra-rater reliability was perfect, achieving 100% consistency in repeated assessments. Observations indicated variations in detecting wound characteristics across different skin tones; sensitivity was notably lower for incisional separation and discolour...