Assessing Pain in Children Just Got a Whole Lot Easier

When a child’s pain is more than just a “boo-boo,” determining the severity of the pain and a course of action can be extremely challenging.

New technology has shown promising results when it comes to assessing children’s pain levels after surgery. Senior author Jeannie Huang, MD, MPH, and a team from the San Diego School of Medicine of the University of California developed real-time facial pattern recognition software to better monitor pain — a factor that is essential for proper healing.

“The current gold standard for measuring pain is self-reporting,” Huang said in a news release. “But in pediatrics there is a limited population of kids who can answer that question in a meaningful way.”

To test the facial recognition software, the researchers analyzed 50 patients (ages 5 to 18) who had laparoscopic appendectomies. Each participant was filmed during 3 separate post-surgery visits — including after 24 hours, one day after the first visit, and 2 to 4 weeks following the appendectomy. The technology recognizes facial expressions such as a wrinkled nose, tightened eyelids, opened mouth, lowered eyebrows, and more. In addition, the team collected self-reported pain levels as well as assessments from the medical staff and the children’s parents.

“Younger children can have difficulty — a two-year-old hasn’t developed the cognitive and conceptual abilities to think in those terms,” Huang explained.

Previous research has used the Facial Action Coding System (FACS), which utilizes 46 anatomical movements, to determine pain. However, this study converted the FACS based data into numerical scores to be compared to patient reported levels. According to the research published in Pediatrics, the system had “good-to-excellent” outcomes in predicting measurements.

“Overall, this technology performed equivalent to parents and better than nurses,” Huang confirmed. “It also showed strong correlations with patient self-reported pain ratings.”

One of the challenges associated with determining a child’s pain is that nurses tend to underestimate the severity. Not only can this make the recovery process more uncomfortable, but the under-treatment can lead to adverse effects. Although the software proved to have accurate results, it may take some time before it starts popping up in the doctor’s office.

“It still needs to be determined whether such a tool can be easily integrated into clinical workflow and thus add benefit to current clinical pain assessment methods and ultimately treatment paradigms,” Huang concluded.