Understanding Unspoken Pain

Pain. While most adults can express this quite easily (and quite loudly even), it’s a different situation with infants or kids who are unable to talk.

But now, new research led by Dr. Ran Goldman, a researcher and emergency physician at BC Children’s Hospital, has shown that facial recognition software technology could improve how health care providers measure pain in young children. If proven successful, this technology could provide helpful guidance for pain management in young children, or in children unable to express pain.

It would be a huge step forward in pain assessment for kids. Until now, the Face, Legs, Activity, Cry, Consolability (FLACC) scale has been commonly used to measure a child’s pain by observing visual cues like crying, grimacing, smiling or kicking out their legs. But despite how often it’s used, it is rather complex to evaluate, and those assessing the pain need to be trained to use the FLACC. Generally, the score was used for research purposes and not so much at the bedside.

Dr. Goldman’s study involved taking several photos of 67 children before, during and after blood tests with needles through the skin. These photos were then uploaded onto a Microsoft software program called Emotion Application Programming Interface, which plotted the level of eight emotions. The study team calculated changes before and after the tests. The research was then corroborated with results using FLACC, and concluded that drawing blood with needles caused an increase in ‘sadness’ and a decrease in ‘neutral’ emotions.

The next step in this research is to validate the results gathered so far by assessing how this technology works in older children who are able to communicate their pain, and determine how well this technology might work for all children.

“More work is needed to determine how accurate and reliable this method can be, but if using a camera on the phone to assess pain proves to be reliable, it would be revolutionary,” said Dr. Goldman. “It’s fast and anyone can use this method to measure pain in real time. In the future, this system could even be used by parents from home for virtual or remote visits to the doctor or emergency room.”

Dr. Ran Goldman was able to advance this innovative research thanks to a catalyst grant—which provides the funds researchers need to pursue their big ideas, and is made possible through the support of donors.

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