Evidence map›Paper›PMID 41073106›Full record

ArticleBMJ health & care informatics2025

Machine learning model to classify chronic leg wounds and identify pyoderma gangrenosum.

Dorothee A Busch, Mats L Richter, Jens Hüsers, Mareike Przysucha, Florian Kücking, Jonathan M Mang, Maurice Moelleken, Joachim Dissemond, Jan Heggemann, Guido Hafer and 3 more

Abstract read
In one paragraph

Article in BMJ health & care informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dorothee A BuschHealth Informatics Research Group, Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences, Osnabrück, Germany d.busch@hs-osnabrueck.de.ORCID http://orcid.org/0000-0001-5176-8157
Mats L RichterMila Quebec Artificial Intelligence Institute, Montreal, Québec, Canada.
Jens HüsersHealth Informatics Research Group, Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences, Osnabrück, Germany.
Mareike PrzysuchaHealth Informatics Research Group, Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences, Osnabrück, Germany.
Florian KückingHealth Informatics Research Group, Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences, Osnabrück, Germany.
Jonathan M MangMedical Center for Information and Communication Technology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany.
Maurice MoellekenDepartment of Dermatology, Venerology and Allergology, University Hospital Essen, Essen, Germany.
Joachim DissemondDepartment of Dermatology, Venerology and Allergology, University Hospital Essen, Essen, Germany.
Jan HeggemannChristian Hospital Melle, Niels-Stensen-Kliniken GmbH, Osnabrück, Germany.
Guido HaferChristian Hospital Melle, Niels-Stensen-Kliniken GmbH, Osnabrück, Germany.
Carola BerkingDepartment of Dermatology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany.
Cornelia Erfurt-BergeDepartment of Dermatology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany.
Ursula H HübnerHealth Informatics Research Group, Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences, Osnabrück, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesChronic wounds represent a significant economic and personal burden. For their successful treatment, the causes must be known and treated. Wounds caused by pyoderma gangrenosum (PG), a rare inflammatory skin disease, are often misdiagnosed. This study, therefore, aims to develop a machine learning model capable of differentiating PG from other wound types, focusing on chronic leg wounds to address this diagnostic challenge.

methodsWe used 3674 wound photographs from three specialised wound centres with the four most common types of foot and leg ulcers and the rare inflammatory differential diagnosis PG. The convolutional neural network classifier ConvNeXt 'B' was pretrained on LAION2B, ImageNet12k and ImageNet 1k before being trained and fine-tuned on an 85:15 train, validation split.

resultsThe model achieved an overall high accuracy in multiclass classification of the chronic wounds (unbalanced accuracy 90%, balanced accuracy 87%). The sensitivity for identifying PG was 94%, while the sensitivity forother chronic wound types was 97% for diabetic foot ulcers (DFU), 92% for venous leg ulcers (VLU), 78% for mixed leg ulcers and 74% for arterial leg ulcers. DISCUSSION: The machine learning model effectively differentiates PG from the most common leg and foot ulcers and was very accurate for classifying DFU and VLU. A higher rate of misclassifications occurred for the other vascular ulcers, that is, mixed and arterial leg ulcers. This aligns with the challenges in clinical practice.

conclusionDespite the limited number of wound images, this novel multiclass wound classification model accurately identified PG and differentiated leg and foot ulcer subtypes, providing a foundation for a diagnostic support system.

Indexed as

Leg UlcerMachine LearningPyoderma GangrenosumChronic DiseaseDiabetic FootDiagnosis, DifferentialFemaleHumansMaleNeural Networks, ComputerArtificial intelligenceDecision Making, Computer-AssistedDecision Support Systems, ClinicalMachine LearningMedical Informatics

Identifiers

PMID41073106
PMCPMC12517012

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.