Expert consensus identifies priorities for continuous prosthetic health monitoring in diabetic amputees
- 1Mechanical Engineering Department, College of Engineering, Al-Nahrain University
- 2Department of Orthopedics, College of Medicine, Al-Nahrain University
Abstract
Diabetic amputees face elevated risks of skin breakdown, infection, and vascular problems, so far, no consensus-driven framework identifies which health domains should be prioritized critically for continuous monitoring in prosthetic environments. This article sought to establish an expert-consensus hierarchy of monitoring priorities to guide the development of future sensor-based prosthetic health-monitoring systems. A three-round Delphi survey was completed by 12 specialists who scored nine predefined health-monitoring domains using a weighted (Severity 40%—Frequency 30%—Preventability 30%) model. Median and interquartile range (IQR) guided round-to-round convergence. Final agreement was measured using Kendall’s W, and inter-rater reliability using ICC (3,1). Bootstrap resampling with 5000 iterations and jackknife sensitivity analysis were used to examine ranking stability. Final expert agreement was Kendall’s W = 0.98, and inter-rater reliability was ICC (3,1) = 0.96. Skin integrity and wound monitoring ranked first, followed by blood flow and vascular health, and temperature monitoring. Humidity and moisture accumulation, sweat and pH levels, and real-time data collection and alerts formed a middle-priority group. Mechanical stability and prosthetic fit, mental and emotional well-being, and battery life and power efficiency were ranked lower but remained relevant supporting domains. Ranking stability was supported by bootstrap and jackknife analyses. This study provides an expert-consensus hierarchy of monitoring priorities for diabetic amputees. The findings may help guide future sensor selection, prosthetic-interface monitoring, and research design. However, the hierarchy should not be interpreted as a clinically validated monitoring protocol, and further patient-centered and real-world validation is required.
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BibTeX
@article{abdulhasan2026expert,
title = {{Expert consensus identifies priorities for continuous prosthetic health monitoring in diabetic amputees}},
author = {Mohammed Q. Abdulhasan and Jumaa S. Chiad and Firas M. Abdulghani},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-61634-z},
url = {https://doi.org/10.1038/s41598-026-61634-z},
note = {CC BY},
}
RIS
TY - JOUR
TI - Expert consensus identifies priorities for continuous prosthetic health monitoring in diabetic amputees
AU - Mohammed Q. Abdulhasan
AU - Jumaa S. Chiad
AU - Firas M. Abdulghani
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-61634-z
UR - https://doi.org/10.1038/s41598-026-61634-z
AB - Diabetic amputees face elevated risks of skin breakdown, infection, and vascular problems, so far, no consensus-driven framework identifies which health domains should be prioritized critically for continuous monitoring in prosthetic environments. This article sought to establish an expert-consensus hierarchy of monitoring priorities to guide the development of future sensor-based prosthetic health-monitoring systems. A three-round Delphi survey was completed by 12 specialists who scored nine predefined health-monitoring domains using a weighted (Severity 40%—Frequency 30%—Preventability 30%) model. Median and interquartile range (IQR) guided round-to-round convergence. Final agreement was measured using Kendall’s W, and inter-rater reliability using ICC (3,1). Bootstrap resampling with 5000 iterations and jackknife sensitivity analysis were used to examine ranking stability. Final expert agreement was Kendall’s W = 0.98, and inter-rater reliability was ICC (3,1) = 0.96. Skin integrity and wound monitoring ranked first, followed by blood flow and vascular health, and temperature monitoring. Humidity and moisture accumulation, sweat and pH levels, and real-time data collection and alerts formed a middle-priority group. Mechanical stability and prosthetic fit, mental and emotional well-being, and battery life and power efficiency were ranked lower but remained relevant supporting domains. Ranking stability was supported by bootstrap and jackknife analyses. This study provides an expert-consensus hierarchy of monitoring priorities for diabetic amputees. The findings may help guide future sensor selection, prosthetic-interface monitoring, and research design. However, the hierarchy should not be interpreted as a clinically validated monitoring protocol, and further patient-centered and real-world validation is required.
SN - 2045-2322
ER -