FAIDEN: exploring the use of artificial intelligence for diabetic foot syndrome

Diabetic foot ulceration (DFU) is a common cause of morbidity and mortality due to infection and peripheral ischemia. Wound infection often leads to severe life-threatening situations with comorbidities such as heart failure, chronic kidney failure, major amputations, perioperative risks, and extended hospitalization worldwide. These amputations represent incredible pressure on public healthcare budgets and are largely avoidable and preventable with current technology.

Eduard Fosch-Villaronga from the eLaw Center of Law and Digital technologies from Leiden Law School and Louk P. van Doorn from the Vascular Surgery Department at Leiden University Medical Centre in the Netherlands joined forces through the FAIDEN project to explore the use of artificial intelligence for diabetes and secondary prevention of diabetic foot problems. They present an idea of an AI-driven smartbox to be used by patients at home, to prevent them from events such as chronic ulceration, infection, and amputation.

The project was one of the four winning ideas in the DT4REGIONS Ideathon held in autumn 2022. Learn more about the Ideathon here and the winners here.

The goal of the FAIDEN project

The goal of the project FAIDEN: Exploring the use of Artificial Intelligence for Diabetic Foot Syndrome is to ensure the system is user-centric and adheres to clinical and trustworthiness standards set by the EU. In concrete, AI will help in the following:

1. Early detection. AI software can identify early signs of severe foot problems in diabetic patients by analyzing unstructured data and EHRs in days and help schedule earlier treatment. 
2. Secondary prevention. In combination with a minimalistic UX, different sensors for temperature, 3d scanning, and image recognition, AI can support daily foot monitoring at home.
3. At home, user-friendly labels identifying risk levels can empower patients for treatment adherence and compliance. 
4. In the future, the knowledge generated can fuel DFS databases to become better and more accurate at diagnosing DFS over time. This knowledge can help streamline health provider decisions over treatment choice and budget allocation.

A project with different impacts

Our project has medical, societal, scientific, and economic impacts:

1. Medical. Diabetic foot ulceration (DFU) is a common cause of morbidity and mortality due to infection and peripheral ischemia. Wound infection (including osteomyelitis) often leads to severe life-threatening situations with comorbidities such as heart failure, chronic kidney failure, major amputations, perioperative risks, and extended hospitalization. Early detection of symptoms occurring in serious foot emergencies, e.g., temperature differences, ulceration, deformity, and changes in peripheral circulation, makes it possible to intervene at an early stage and prevent the situation from deteriorating, ultimately leading to better general health and quality of life.  
2. Scientific and economical. Our project advances the knowledge of using AI for preventive medicine in a largely unattended area of research, i.e., diabetic foot syndrome. Monitoring diabetic patients and early interventions will radically shift our current interventions from reactive to active. Accessible and affordable smart boxes will ensure diabetic patients with a risk of diabetic foot disease can benefit from it. Preventing ulceration will represent a massive relief to health budgets since the costs for ulceration and amputation in diabetes in 2014-2015 is estimated at between £837 million and £962 million, 0.8% to 0.9% of the National Health Service (NHS) budget for England.
3. Ethical, Legal, and Societal. Losing a limb has enormous life-changing consequences. Our project will improve patients' quality of life and contribute towards a more personalized, trustworthy understanding of AI for medicine. Moreover, our project will empower patients with disease education, which are often not in the position to assess the gravity of their situation, to make easier choices that may ulteriorly impact their health and lives.