Analisis Kemampuan Diagnostik Aplikasi Smartphone ImitoMeasure – Measure Wounds dalam Pengkajian Luka Kaki Diabetik sebagai Alternatif Telemedicine di RSUP H. Adam Malik Medan

Abstract

Introduction: Diabetic foot ulcer (DFU) remains one of the most debilitating complications of diabetes mellitus, associated with high morbidity, prolonged hospitalization, and increased risk of amputation. Accurate wound assessment is crucial for optimizing management, yet conventional manual measurement is limited by inaccuracy and lack of standardization. The integration of smartphone-based applications offers a potential alternative within the framework of telemedicine, particularly in resource-limited settings. Objective: To compare the diagnostic performance of the ImitoMeasure smartphone application against manual ruler-based wound assessment in patients with DFU, and to evaluate its potential as a telemedicine tool at Adam Malik General Hospital, Medan. Methods: This diagnostic test study involved 76 type 2 diabetes patients with DFUs (April–May 2025). Ulcer size (length, width, area) was measured manually with a ruler and digitally with ImitoMeasure under standardized imaging. Diagnostic performance was evaluated using ROC curves and AUC analysis. Results: The mean age of participants was 54.8 ± 10.5 years, with male predominance (53.1%). Manual wound measurement yielded a mean length of 5.94 ± 2.87 cm and width of 3.61 ± 1.74 cm, while ImitoMeasure reported higher values (length 7.49 ± 3.75 cm; width 4.33 ± 1.70 cm). The application also calculated wound surface area (mean 26.14 ± 19.47 cm²) and perimeter (mean 19.09 ± 8.62 cm). ROC analysis demonstrated poor diagnostic agreement, with AUC values of 0.375 for length and 0.376 for area. Conclusion: The ImitoMeasure app offers practical advantages in digital documentation but shows limited accuracy compared to manual measurement. Though not ready to replace conventional methods, it holds potential as a supportive telemedicine tool, requiring further calibration and algorithm refinement before clinical use.