Pain Reporter: Interview with Jeannie Huang, MD, MPH

You know how when you’re in pain your face tenses up? Involuntarily your nose may wrinkle, your eyes may squeeze closed, and your brows may furrow. There’s new computer vision algorithm that can assess pain levels from these facial expressions. In the June 1 online edition of the journal Pediatrics, researchers at UC San Diego described a new technology that could be of value in gauging pain and also possibly help determine medication dosage levels postsurgery.

The PAINWeek.org Pain Reporter interviewed Jeannie Huang, MD, MPH, the a senior author of a study of facial recognition software to help children and others in pain.

Jeannie Huang, MD, MPH, a professor in the UC San Diego School of Medicine Department of Pediatrics and a gastroenterologist at Rady Children's Hospital, San Diego, was kind enough to answer a few questions:

What steered you and your research team to develop this software?

I am a pediatric gastroenterologist and was frustrated with the current methods by which we assess pain in youth of all ages in my clinical practice. This was the main impetus for me and ultimately our team to seek out a solution.

How did you evaluate the computer finding?

We compared software-generated pain scores with pain scores reported by parents and caregivers who were asked to observe their children's faces and report what pain level they believed their child was experiencing at the time. We also compared these software-generated pain scores to scores reported by children at the same time and demonstrated strong correlations here as well. Currently self-report of pain is the gold standard by which we measure pain in patients. As one can imagine, this pain report can be problematic in the very young and in youth who have developmental or communication disabilities. Similarly, the same problems exist in the elderly and in patients with dementia.

What do you think about the general state of pain management in the US today?

Pain management is hampered by our limited ability to adequately assess pain in patients. Pain management requires clinicians to be able to reliably and accurately assess pain across patients and over time. The current pain reporting method (self-report) has notable deficiencies in these areas, and one can easily project comparable application to other vulnerable populations such as children, the elderly, and patients with cognitive, developmental, and/or communication issues.

In a perfect world, how would you like to see this software best utilized?

Ideally, I would like to see the current pain assessment method improved upon. I see great promise in our software to provide this improvement and additional data to clinicians in a timely fashion—since it can provide pain assessments in real time—so that pain management can be effectively and efficiently delivered to those most in need.  I think this can be accomplished with current technologies in the clinical care arena where there is great need, but there remains work to be done to make this happen.

What is a dream project you hope to work on?

I am interested in performing a number of studies to bring the dream (mentioned above) to a reality. This would include evaluating pain in other patient populations to determine generalizability and in vulnerable patient populations to determine feasibility, utility, and efficacy in measuring pain. Ultimately, we would also like to test this software/tool in the clinical arena and see how it might fit into clinical workflow. We believe that this realtime system will help identify pain when it happens and alert the system. The current hurdle to this dream is funding. The need, recognition, and the desire to improve and invest in improving pain assessment are already present in both patients and clinicians. We would like to continue our work to improve pain assessment and control for all patients across the life spectrum.

Thank you, Dr. Huang!

For more information:

To read about children, pain, and the benefits of music therapy, click here.

To read about children and neuropathic pain, click here.

For a link to a journal article about children and pain self-reporting, click here.

For a link to the journal Pediatrics, click here.

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