{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:59:19Z","timestamp":1784912359463,"version":"3.55.0"},"reference-count":98,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund (QNRF)","doi-asserted-by":"publisher","award":["NPRP12S-0227-190164"],"award-info":[{"award-number":["NPRP12S-0227-190164"]}],"id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund (QNRF)","doi-asserted-by":"publisher","award":["IRCC-2021-001"],"award-info":[{"award-number":["IRCC-2021-001"]}],"id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund (QNRF)","doi-asserted-by":"publisher","award":["DPK-2021-001"],"award-info":[{"award-number":["DPK-2021-001"]}],"id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004252","name":"International Research Collaboration Co-Fund (IRCC)","doi-asserted-by":"publisher","award":["NPRP12S-0227-190164"],"award-info":[{"award-number":["NPRP12S-0227-190164"]}],"id":[{"id":"10.13039\/501100004252","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004252","name":"International Research Collaboration Co-Fund (IRCC)","doi-asserted-by":"publisher","award":["IRCC-2021-001"],"award-info":[{"award-number":["IRCC-2021-001"]}],"id":[{"id":"10.13039\/501100004252","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004252","name":"International Research Collaboration Co-Fund (IRCC)","doi-asserted-by":"publisher","award":["DPK-2021-001"],"award-info":[{"award-number":["DPK-2021-001"]}],"id":[{"id":"10.13039\/501100004252","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["NPRP12S-0227-190164"],"award-info":[{"award-number":["NPRP12S-0227-190164"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["IRCC-2021-001"],"award-info":[{"award-number":["IRCC-2021-001"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["DPK-2021-001"],"award-info":[{"award-number":["DPK-2021-001"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Diabetes mellitus (DM) is one of the most prevalent diseases in the world, and is correlated to a high index of mortality. One of its major complications is diabetic foot, leading to plantar ulcers, amputation, and death. Several studies report that a thermogram helps to detect changes in the plantar temperature of the foot, which may lead to a higher risk of ulceration. However, in diabetic patients, the distribution of plantar temperature does not follow a standard pattern, thereby making it difficult to quantify the changes. The abnormal temperature distribution in infrared (IR) foot thermogram images can be used for the early detection of diabetic foot before ulceration to avoid complications. There is no machine learning-based technique reported in the literature to classify these thermograms based on the severity of diabetic foot complications. This paper uses an available labeled diabetic thermogram dataset and uses the k-mean clustering technique to cluster the severity risk of diabetic foot ulcers using an unsupervised approach. Using the plantar foot temperature, the new clustered dataset is verified by expert medical doctors in terms of risk for the development of foot ulcers. The newly labeled dataset is then investigated in terms of robustness to be classified by any machine learning network. Classical machine learning algorithms with feature engineering and a convolutional neural network (CNN) with image-enhancement techniques are investigated to provide the best-performing network in classifying thermograms based on severity. It is found that the popular VGG 19 CNN model shows an accuracy, precision, sensitivity, F1-score, and specificity of 95.08%, 95.08%, 95.09%, 95.08%, and 97.2%, respectively, in the stratification of severity. A stacking classifier is proposed using extracted features of the thermogram, which is created using the trained gradient boost classifier, XGBoost classifier, and random forest classifier. This provides a comparable performance of 94.47%, 94.45%, 94.47%, 94.43%, and 93.25% for accuracy, precision, sensitivity, F1-score, and specificity, respectively.<\/jats:p>","DOI":"10.3390\/s22114249","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T08:01:18Z","timestamp":1654243278000},"page":"4249","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["A Novel Machine Learning Approach for Severity Classification of Diabetic Foot Complications Using Thermogram Images"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7068-9112","authenticated-orcid":false,"given":"Amith","family":"Khandakar","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering, Qatar University, Doha 2713, Qatar"},{"name":"Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-8206","authenticated-orcid":false,"given":"Muhammad E. H.","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Qatar University, Doha 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0459-0365","authenticated-orcid":false,"given":"Mamun Bin Ibne","family":"Reaz","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4819-863X","authenticated-orcid":false,"given":"Sawal Hamid Md","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Kiranyaz","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Qatar University, Doha 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6938-6496","authenticated-orcid":false,"given":"Tawsifur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Qatar University, Doha 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-5067","authenticated-orcid":false,"given":"Moajjem Hossain","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8663-886X","authenticated-orcid":false,"given":"Mohamed Arselene","family":"Ayari","sequence":"additional","affiliation":[{"name":"Department of Civil and Architectural Engineering, Qatar University, Doha 2713, Qatar"},{"name":"Technology Innovation and Engineering Education Unit, Qatar University, Doha 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashad","family":"Alfkey","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and General Surgery, Hamad Medical Corporation, Doha 3050, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9060-0346","authenticated-orcid":false,"given":"Ahmad Ashrif A.","family":"Bakar","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine-Qatar, Ar-Rayyan 24144, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwarul","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Industrial and Mechanical Engineering, Qatar University, Doha 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"ref_1","unstructured":"Cho, N., Kirigia, J., Mbanya, J., Ogurstova, K., Guariguata, L., and Rathmann, W. 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