Predicting Vasovagal Reactions to Needles from Facial Action Units

Abstract

Background: Merely the sight of needles can cause extreme emotional and physical (vasovagal) reactions (VVRs). However, needle fear and VVRs are not easy to measure nor prevent as they are automatic and difficult to self-report. This study aims to investigate whether a blood donors’ unconscious facial microexpressions in the waiting room, prior to actual blood donation, can be used to predict who will experience a VVR later, during the donation. Methods: The presence and intensity of 17 facial action units were extracted from video recordings of 227 blood donors and were used to classify low and high VVR levels using machine-learning algorithms. We included three groups of blood donors as follows: (1) a control group, who had never experienced a VVR in the past (n = 81); (2) a ‘sensitive’ group, who experienced a VVR at their last donation (n = 51); and (3) new donors, who are at increased risk of experiencing a VVR (n = 95). Results: The model performed very well, with an F1 (=the weighted average of precision and recall) score of 0.82. The most predictive feature was the intensity of facial action units in the eye regions. Conclusions: To our knowledge, this study is the first to demonstrate that it is possible to predict who will experience a vasovagal response during blood donation through facial microexpression analyses prior to donation.

Development and validation of a scoring system to predict vasovagal reaction upon whole‐blood donation

“…The importance of the first‐time donor status is well‐established [4, 6, 9, 11, 12]. On the other hand, a few previous studies reported that those who had experienced syncope during a previous donation were at an increased risk of recurrent syncope [15, 16]. As previously reported, our results showed that age was the next most important variable for VVR [4, 6, 11, 12].…”

“…A recent systematic review [3] reported risk factors associated with the development of VVR among whole‐blood donors. The following risk factors were associated with an increased risk of syncope: female sex [4–6], lower body weight [7–9], lower estimated blood volume (EBV) [5, 10, 11], young age [4, 6, 11, 12], first‐time donor [4, 6, 9, 11, 12], low resting blood pressure [7], reduced sleep before donation [13, 14], donation location [11] and previous history of symptoms at blood donation [15, 16].…”