Diabetic Foot Ulcers Detection Model Using a Hybrid Convolutional Neural Networks–Vision Transformers

<b>Background:</b> Diabetic foot ulcers (DFUs) are severe and common complications of diabetes. Early and accurate DFUs classification is essential for effective treatment and prevention of severe complications. The existing DFUs classification methods have certain limitations, including limited performance, poor generalization, and lack of interpretability, restricting their use in clinical settings. <b>Objectives:</b> To overcome these limitations, this study proposes an innovative model to achieve robust and interpretable DFUs classification. <b>Methodology:</b> The proposed DFUs classification integrates MobileNet V3-SWIN, LeViT-Peformer, Tensor-based feature fusion, and ensemble splines-based Kolmogorov-Arnold Networks (KANs) with Shapley Additive exPlanations (SHAP) values to classify DFUs severities into ischemia and infection classes. In order to train and generalize the proposed model, the authors utilized the DFUs challenge (DFUC) 2021 and 2020 datasets. <b>Findings:</b> The proposed model achieved state-of-the-art performance, outperforming the existing approaches by obtaining an average accuracy of 98.7%, precision of 97.3%, recall of 97.4%, and F1-score of 97.3% on DFUC 2021. On DFUC 2020, it maintained a robust generalization accuracy of 96.9%, demonstrating superiority over standalone and baseline models. The study findings have significant implications for research and clinical practice. The findings offer an effective platform for scalable and explainable automated DFUs treatment and management, improving patient outcomes and clinical practices.