Construction of an Artificial Intelligence-assisted System for Automatic Detection of Pressure Injury Based on the YOLO Neural Network

Background With the aging population, the incidence of pressure injury (PI) is gradually increasing. This not only severely impacts the quality of life for patients but also increases healthcare expenditures. However, the early detection and accurate staging of PI heavily depend on specialized training. Objective To construct and validate an artificial intelligence model for the automatic detection and staging of PI aimed at enhancing the real-time nature, accuracy, and objectivity of PI diagnostics. Methods A total of 693 PI images from the electronic management system of pressure ulcers at Changshu No.1 People's Hospital were selected from January 2021 to February 2024, the images were randomly divided into a training set (551 images) and a test set (142 images), and categorized into six stages according to National Pressure Ulcer Advisory Panel (NPUAP) guidelines: StageⅠ (154 images), StageⅡ (188 images), StageⅢ (160 images), StageⅣ (82 images), deep tissue injury (57 images), and unstageable (52 images). A deep learning object detection model for PI was established using five different versions of the YOLOv8 [nano (n), small (s), medium (m), large (l) and extra large (x) ] neural network and transfer learning. The model evaluation metrics included accuracy, sensitivity, specificity, false positive rate, and detection speed. Finally, the model was deployed to a mobile application via the Ultralytics Hub platform, facilitating the application of the AI model in clinical practice. Results During the evaluation of a test set containing 142 PI images, the YOLOv8l version demonstrated high accuracy (0.827) and fast inference speed (68.49 fps), achieving the best balance between precision and speed among the YOLO versions. Specifically, it achieved an overall accuracy of 93.18% across all categories, a sensitivity of 76.52%, a specificity of 96.29%, and a false positive rate of 3.72%. Among the six stages of PI, the model achieved the highest accuracy for StageⅠat 95.97%. The accuracies for StageⅡ, StageⅢ, StageⅣ, deep tissue injury, and unstageable were 91.28%, 91.28%, 91.95%, 95.30%, and 93.29%, respectively. In terms of processing speed, YOLOv8l took a total of 2.07 seconds to process 142 images, averaging 68.49 PI images per second. Conclusion The AI model based on the YOLOv8l network can quickly and accurately detect and stage PI. Deploying this model to a mobile app allows for portable use in clinical practice, demonstrating significant potential for clinical application.