1
Exploiting Machine Learning Algorithms to
Diagnose Foot Ulcers in Diabetic Patients
Shiva Shankar Reddy
1,*
, Gadiraju Mahesh
2
and N. Meghana Preethi
2
1
Research Scholar, Department of Computer Science and Engineering, Biju Patnaik University of Technology,
Rourkela, Odisha, India
2
Department of Computer Science and Engineering, Sagi Rama Krishnam Raju Engineering College, Bhimavaram,
Andhra Pradesh, India
Abstract
INTRODUCTION: Diabetic foot ulcer (DFU) is a complication of diabetes that affects most of the diabetic patients.
It will cause open wounds on the foot. Untreated DFU will lead to amputation and infection, which results in
removal of foot or leg. As diabetes is the major health problem faced by people of all age groups, identifying foot
ulcers at an early stage is essential. In this context, an efficient model to predict the foot ulcer accurately was
proposed in this work.
OBJECTIVES: To predict DFU using an effective neural network algorithm on a suitable dataset that consists of
risk factors and clinical outcomes of the disease.
METHODS: In recent days, ML techniques are most commonly used for predicting various diseases. To achieve
the objectives a neural network technique, namely extreme learning machine (ELM) is proposed to predict DFU
accurately. In addition, three existing algorithms, namely KNN, SVM with Gaussian kernel and ANN are also
considered. These are implemented in R programming.
RESULTS: Algorithms compared in terms of five evaluation metrics accuracy, zero-one loss, threat score/critical
success index (TS/CSI), false omission rate (FOR) and false discovery rate (FDR). The values of accuracy, 0-1
loss, TS/CSI, FOR and FDR obtained for ELM are 96.15%, 0.0385, 0.95, 0 and 0.05 respectively.
CONCLUSION: After comparison, it was discovered that ELM had outperformed other algorithms in terms of all
the metrics. Thus, it was recommended to use ELM over other algorithms while predicting diabetic foot ulcers.
Keywords: Diabetic foot ulcer, KNN, SVM with Gaussian kernel, artificial neural network (ANN), extreme learning machine
(ELM), accuracy, zero-one loss, critical success index (CSI), false omission rate (FOR) and false discovery rate (FDR).
Received on 11 June 2021, accepted on 12 August 2021, published on 24 August 2021
Copyright © 2021 Shiva Shankar Reddy et al., licensed to EAI. This is an open access article distributed under the terms of
the Creative Commons Attribution license, which permits unlimited use, distribution and reproduction in any medium so
long as the original work is properly cited.
doi: 10.4108/eai.24-8-2021.170752
1. Introduction
Diabetes leads to several complications where foot ulcers are
one of them. This disease occurs in type-1 and type-2 diabetic
patients. In type-1 diabetic patients, there will be no insulin
production or produced in less quantity, so that the patient
should depend on insulin injections. In type-2 diabetic
patients, insulin will be produced, but it was not sufficient for
*
Corresponding author. Email: shiva.shankar591@gmail.com
the body's functioning. In type-2, the diabetic patient is given
medication instead of insulin injections [1].
Long term suffering of either type-1 or type-2 diabetes
increases the risk of affecting diabetic foot ulcers. A Diabetic
foot ulcer is a condition where the diabetic patient will suffer
from a wounded foot. It mostly occurs on the bottom of the
foot and stays open. Nearly 15% of diabetic patients will be
affected by foot ulcers. Among those people, about 6% are
hospitalized because of further complications. On average,
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10 2021 - 11 2021 | Volume 7 | Issue 29 | e2