Automated Assessment of Peristomal Skin Discoloration and Leakage Area Using Artificial Intelligence

For people living with an ostomy, development of peristomal skin complications (PSCs) is the most common post-operative challenge. A visual sign of PSCs is discoloration (redness) of the peristomal skin often resulting from leakage of ostomy output under the baseplate. If left unattended, a mild skin condition may progress into a severe disorder; consequently, it is important to monitor discoloration and leakage patterns closely. The Ostomy Skin Tool is current state-of-the-art for evaluation of peristomal skin, but it relies on patients visiting their healthcare professional regularly. To enable close monitoring of peristomal skin over time, an automated strategy not relying on scheduled consultations is required. Several medical fields have implemented automated image analysis based on artificial intelligence, and these deep learning algorithms have become increasingly recognized as a valuable tool in healthcare. Therefore, the main objective of this study was to develop deep learning algorithms which could provide automated, consistent, and objective assessments of changes in peristomal skin discoloration and leakage patterns. A total of 614 peristomal skin images were used for development of the discoloration model, which predicted the area of the discolored peristomal skin with an accuracy of 95% alongside precision and recall scores of 79.6 and 75.0%, respectively. The algorithm predicting leakage patterns was developed based on 954 product images, and leakage area was determined with 98.8% accuracy, 75.0% precision, and 71.5% recall. Combined, these data for the first time demonstrate implementation of artificial intelligence for automated assessment of changes in peristomal skin discoloration and leakage patterns.