Is Your Child in Pain? You Can Tell, But Can the Doctor?

What if you could tell when your child was really in pain?

I’m not talking to fake not going to school or having to do a report or to apologize for not cleaning his room.

We’re talking real pain.  As a mother (and even a father) you can probably tell when your child is hurting.  But doctors can’t.  So now, according to a new study, they’ve developed software that can, just from their facial expressions.

Sound a little Hunger Gameish?  It isn’t.

It's being used not only to help with alleviating it, but also in recovery.

Researchers used the software to analyze pain-related facial expressions from video taken of 50 youths, ages five to 18 years old, who had undergone laparoscopic appendectomies at Rady Children’s Hospital-San Diego, according to Based on the analysis, along with clinical data input by the study team, the software provided pain level scores for each participant.

Studies have shown that under-treatment of pain is associated with adverse surgical outcomes. 

Several issues, particularly age-related communication difficulties, make existing pediatric pain assessment methods problematic, researchers say. Patients are generally asked to rate their pain on a scale of zero to 10. “But in pediatrics there is a limited population of kids who can answer that question in a meaningful way," says senior author 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. "Younger children can have difficulty - a two-year-old hasn’t developed the cognitive and conceptual abilities to think in those terms.”  

Worryingly, several previous studies have shown nursing staff may have difficulty accurately estimating pain (often underestimating pain), particularly among pediatric patients. Parents are generally more in tune with their children’s pain levels, but may not always be available, says Huang.

Another problem with pain assessment protocols, Huang adds, is that pain checks tend to be scheduled and consequently may not coincide with times when pain occurs and when intervention is needed. “Pain assessments are typically scheduled along with vital signs, the frequency of which can vary from every 4 to 8 hours depending on patient severity," she notes.

As anyone who has been in pain in a healthcare setting and has to wait for meds, that can be extremely difficult.  Imagine it as a child and, well, it's better not to go there.

The research team sought to determine the software’s accuracy at pain measurement as compared to self-reporting by the child and as compared to by proxy estimations by parents and nurses.

This project took facial movement and pain analysis one step further than earlier studies. In the software prototype, the study’s authors translated the facial movement data into a pain score and then compared that with the information collected from the child’s self-reporting and the parent and nurse by proxy pain estimations. 

“The software demonstrated good-to-excellent accuracy in assessing pain conditions,” said Huang. “Overall, this technology performed equivalent to parents and better than nurses. It also showed strong correlations with patient self-reported pain ratings.” The software also did not demonstrate bias in pain assessment by ethnicity, race, gender, or age in the patient cohort studied.

The really good news is that this new software allows doctors and nurses to assess pain when it's actually happening, not just when they come in to check blood pressure, and alleviate it then and there.  


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