Learn about CARES4WOUNDS in the International Wounds Journal

May 25, 2021 karina

A study on CARES4WOUNDS (C4W-B), conducted by Tan Tock Seng Hospital (TTSH), was published in the International Wound Journal (IWJ)—a leading journal for wound professionals globally. Below, we have highlighted the key findings from this study.


The lifetime risk of developing diabetic foot ulcers (DFUs) for patients with diabetes mellitus is 15% to 25%. DFUs need to be constantly followed up on and assessed for any new developments, traditionally these measurements were performed manually. The study aims to compare both the intra-rater and inter-rater reliability of C4W-B, an artificial intelligence-enabled wound imaging mobile application, with traditional wound measuring methods.

Intra-rater and inter-rater reliability was analysed using intra-class correlation statistics. Values less than 0.5 indicates poor reliability, while values greater than 0.9 indicate excellent reliability. Results showed that the intra-rater reliability of C4W-B ranged from 0.933–0.994. While the inter-rater reliability between three C4W devices for length, width, and area observed was 0.947, 0.923 and 0.965, respectively.

As a whole, C4W-B showed excellent intra-rater and inter-rater reliability.

Additionally, when compared to international counterparts, it was determined that CARES4WOUNDS was non-inferior.

Overall, it was concluded by TTSH that C4W-B is a useful adjunct in monitoring DFU wound progress.

For more information on the difference between intra-rater and inter-rater reliability, please see this video.

Source: Chan KS, Chan YM,Tan AHM, et al. Clinical validation of an artificial intelligence-enabled wound imaging mobile application in diabetic foot ulcers. Int Wound J.2021;1–11.https://doi.org/10.1111/iwj.13603