Looking at neonatal facial features of pain: do health and non-health professionals differ?

et al. 2023

Electronics Letters

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Newborn infants are exposed to painful experiences, routinely practised clinically, that might increase their short‐ and long‐term morbidity and mortality. Facial expression has been widely used in clinical practice to assess pain in newborns. However, the inherent human visual attention required to make such vital inference is poorly understood. It is also unknown whether this inference occurs differently when comparing health professionals with non‐health ones. To investigate these issues, the authors have recorded and monitored the pupil size signal of 102 subjects (44 experts, 29 parents, and 29 non‐experts) while visually analyzing 20 frontal face images of 10 distinct newborns after a painful procedure (positive stimulus) and at painless rest (negative stimulus). Our experimental results show that neonatal pain assessment is more cognitively demanding when analyzing the presence of pain rather than its absence. In addition, the pupil responses for both positive and negative stimuli and all sample groups of subjects present experimentally a common temporal pattern, disclosing that a 2‐s exposure to a facial expression is sufficient to make this assessment, regardless of whether performed by health professionals or non‐health ones.

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Section: Resultsmentioning

confidence: 99%

Visual attention during neonatal pain assessment: A 2‐s exposure to a facial expression is sufficient

Orsi

et al. 2023

Electronics Letters

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“…al [13] originally reported that there was no difference in the recognition accuracy of facial expression of pain in newborns between health professionals and parents when analyzing the face of full-term infants in an analogous experiment using printed photographs. Recently, researchers have found as well that such classification accuracy is not only similar, but also based holistically on the same facial parts [7,11,14,8]. However, since the sample group of non-experts is composed of subjects with neither professional nor personal experience on attempting to score pain in newborns, non-experts have in general overestimated the presence of pain in the experimental setting carried out, showing the worst classification results on the painless rest situations of negative stimuli.…”

Section: Methodsmentioning

confidence: 99%

Visual attention during neonatal pain assessment: A 2-second exposure to a facial expression is sufficient

Orsi

et al. 2022

Preprint

Facial expression has been widely used in clinical practice to assess pain in newborns. However, the inherent visual attention required to make such vital inference is poorly understood. It is also unknown whether this inference occurs differently when comparing health professionals with other adults. To investigate these issues, we have recorded and monitored the pupil size signal of 102 subjects (44 experts, 29 parents, and 29 non-experts) while visually analyzing 20 frontal face images of 10 distinct newborns after a painful procedure and at painless rest. Our experimental results have showed that neonatal pain assessment is more cognitively demanding when analyzing the presence of pain rather than its absence. Moreover, our results disclose that a 2-second exposure to a facial expression is sufficient to make this assessment, regardless whether done by health professionals or non-health ones, suggesting that this highly specific visual task is not driven by clinical experience.

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“…Therefore, studies that seek to understand this information, extracted from both human and machine eyes, can help to create models that combine these two types of learning. Examples of such studies would be those of Silva et al 48 Barros et al 49 and Soares et al 50 that used gaze tracking of observers during newborn pain assessment; and research using eXplainable Artificial Intelligence (XAI) models, such as those of Carlini et al 23 and Coutrin et al 51…”

Section: Perspectivesmentioning

confidence: 99%

Face-based automatic pain assessment: challenges and perspectives in neonatal intensive care units

Buzuti

et al. 2023

Jornal de Pediatria

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