{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:08:45Z","timestamp":1791598125055,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100030794","name":"Skin Research Institute of Singapore","doi-asserted-by":"publisher","award":["H17\/01\/a0\/0Y9"],"award-info":[{"award-number":["H17\/01\/a0\/0Y9"]}],"id":[{"id":"10.13039\/100030794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diabetes is a leading cause of morbidity and mortality, contributing to complications such as cardiovascular disease, kidney failure and lower\u2010limb amputations. Diabetic foot complications, such as structural deformities, ulceration and infection, present significant risks, necessitating early detection and intervention. This study explores the development and validation of artificial intelligence (AI) image analysis for diabetic foot screening, focusing on structural deformity identification which includes callus, hallux valgus and hammer toes, because they represent the earliest detectable visual risk markers for ulceration, preceding wound formation. Leveraging datasets comprising over 1000 healthy foot images and 215 diabetic foot deformity images, the model employed YOLOv5 for object detection, a convolutional autoencoder for anomaly detection, and DenseNet201 for anomaly classification. Initial internal validation yielded 91.1% anomaly detection accuracy, while anomaly classification accuracy improved to 88.57% following refinement. External validation using 27 participants achieved an overall accuracy of 85.2% and anomaly classification accuracy of 66.7%. Final evaluation on 35 unlabelled images demonstrated promising performance, with 88.57% accuracy, 90.47% precision and an\n                    <jats:italic>F<\/jats:italic>\n                    1 score of 86.11%. Integrated into the \u2018Foot at Risk\u2019 (FAR) mobile application, this AI\u2010driven solution offers a scalable tool for early diabetic foot deformity detection. With larger dataset input for training and development, it can be utilised as an early screening tool for diabetic foot and integrated into existing community diabetic care model, facilitating timely intervention and improving patient outcomes.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70821","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T23:44:25Z","timestamp":1769989465000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validation of a Trained\n                    <scp>AI<\/scp>\n                    Imaging Model for Detecting Diabetic Foot Deformities"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1230-3188","authenticated-orcid":false,"given":"Kher Li","family":"Teoh","sequence":"first","affiliation":[{"name":"Wound and Vascular Centre Woodlands Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khare Shubham","family":"Hari","sequence":"additional","affiliation":[{"name":"Republic Polytechnic  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Lian","family":"Ng","sequence":"additional","affiliation":[{"name":"Tetsuyu Healthcare Holdings Pte Ltd  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2289-5266","authenticated-orcid":false,"given":"Zhiwen Joseph","family":"Lo","sequence":"additional","affiliation":[{"name":"Wound and Vascular Centre Woodlands Hospital  Singapore"},{"name":"Wounds iCare Collaborative Clinical and Research Workgroup, NHG Health  Singapore"},{"name":"A*STAR Skin Research Laboratory  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)01301\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010022\u201005845\u20109"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","unstructured":"S. A.Bus I. C. N.Sacco M.Monteiro\u2010Soares et\u00a0al. \u201cGuidelines on the Prevention of Foot Ulcers in Persons With Diabetes: IWGDF 2023 Update \u201d 2023 International Working Group on the Diabetic Foot (IWGDF) www.iwgdfguidelines.org.","DOI":"10.1007\/s13300-024-01578-7"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40537\u2010019\u20100276\u20102"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13603"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1127647"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1036"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067\u20102516(07)60001\u20105"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13540"},{"key":"e_1_2_12_12_1","unstructured":"Agency for Care Effectiveness (ACE) \u201cFoot Assessment in Patients With Diabetes Mellitus \u201d 2024 ACE Clinical Guidance (ACG) Ministry of Health Singapore go.gov.sg\/acg\u2010dfa."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13481"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2024-004688"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2010.0088"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1386613"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2022.106456"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14565"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12995"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2022.867485"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70821","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.70821","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70821","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:29:08Z","timestamp":1773030548000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/iwj.70821"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70821","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-05-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70821"}}