{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:44:39Z","timestamp":1790016279134,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Diabetic foot ulcer (DFU) is one of the most serious and alarming diabetic complications, which often leads to high amputation rates in diabetic patients. Machine learning is a part of the field of artificial intelligence, which can automatically learn models from data and better inform clinical decision\u2010making. We aimed to develop an accurate and explainable prediction model to estimate the risk of in\u2010hospital amputation in patients with DFU. A total of 618 hospitalised patients with DFU were included in this study. The patients were divided into non\u2010amputation, minor amputation or major amputation group. Light Gradient Boosting Machine (LightGBM) and 5\u2010fold cross\u2010validation tools were used to construct a multi\u2010class classification model to predict the three outcomes of interest. In addition, we used the SHapley Additive exPlanations (SHAP) algorithm to interpret the predictions of the model. Our area under the receiver\u2010operating\u2010characteristic curve (AUC) demonstrated a 0.90, 0.85 and 0.86 predictive ability for non\u2010amputation, minor amputation and major amputation outcomes, respectively. Taken together, our data demonstrated that the developed explainable machine learning model provided accurate estimates of the amputation rate in patients with DFU during hospitalisation. Besides, the model could inform individualised analyses of the patients' risk factors.<\/jats:p>","DOI":"10.1111\/iwj.13691","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T08:48:39Z","timestamp":1631609319000},"page":"910-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["An explainable machine learning model for predicting in\u2010hospital amputation rate of patients with diabetic foot ulcer"],"prefix":"10.1111","volume":"19","author":[{"given":"Puguang","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenzhen","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunli","family":"Rui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Deng","sequence":"additional","affiliation":[{"name":"College of Electronic Information and Automation, Civil Aviation University of China  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9466-7241","authenticated-orcid":false,"given":"Johnson","family":"Boey","sequence":"additional","affiliation":[{"name":"Department of Podiatry National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Surgery Keck School of Medicine of the University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuquan","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University  Chongqing China"},{"name":"College of Bioengineering, Chongqing University of China  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4711-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/2468-8827.184853"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13569"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j5064"},{"issue":"6","key":"e_1_2_9_6_1","first-page":"737","article-title":"Management of ischemic diabetic foot","volume":"54","author":"Caravaggi C","year":"2013","journal-title":"J Cardiovasc Surg"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.293.3473"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1242"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2007.00392.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3273"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12642"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12429"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2431"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.22271\/ortho.2018.v4.i1n.133"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20175401"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.05.007"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2031"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.852"},{"key":"e_1_2_9_19_1","first-page":"217","volume-title":"Reading and Understanding Multivariate Statistics","author":"Wright RE","year":"1995"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1743"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2057"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13425"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2017.00025"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/ryai.2020200088"},{"key":"e_1_2_9_25_1","unstructured":"KeG MengQ FinleyT et al.Lightgbm: a highly efficient gradient boosting decision tree. Paper presented at: Proceedings of the Advances in Neural Information Processing Systems; 2017."},{"key":"e_1_2_9_26_1","unstructured":"BergstraJ BardenetR BengioY K\u00e9glB.Algorithms for hyper\u2010parameter optimization. Paper presented at: Proceedings of the 25th Annual Conference on Neural Information Processing Systems (NIPS 2011)."},{"key":"e_1_2_9_27_1","unstructured":"ZadroznyB ElkanC.Transforming classifier scores into accurate multiclass probability estimates. Paper presented at: Proceedings of the Proceedings of the Eighth ACM SIGKDD International Conference on Knowledge Discovery and Data Mining"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42256-019-0138-9"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.1.84"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v6.29629"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-010-9355-z"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1989.10478874"},{"key":"e_1_2_9_33_1","unstructured":"ChenT GuestrinC.Xgboost: a scalable tree boosting system. Paper presented at: 22nd ACM Sigkdd International Conference on Knowledge Discovery and Data Mining."},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1561\/2000000039"},{"key":"e_1_2_9_35_1","unstructured":"LundbergS LeeS\u2010I.A unified approach to interpreting model predictions. arXiv preprint arXiv:170507874; 2017."},{"key":"e_1_2_9_36_1","unstructured":"LuS ChenR WeiW LuX.Understanding heart\u2010failure patients EHR clinical features via SHAP interpretation of tree\u2010based machine learning model predictions. arXiv preprint arXiv:210311254; 2021."},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11634-020-00418-3"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.12.090"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.11.045"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.10.034"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2018.10.002"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0711-6"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.13691","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T02:10:01Z","timestamp":1770948601000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.13691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,14]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/iwj.13691"],"URL":"https:\/\/doi.org\/10.1111\/iwj.13691","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,14]]},"assertion":[{"value":"2021-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}