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Cascella M, Schiavo D, Cuomo A, Ottaiano A, Perri F, Patrone R, Migliarelli S, Bignami EG, Vittori A, Cutugno F. Artificial Intelligence for Automatic Pain Assessment: Research Methods and Perspectives. Pain Res Manag 2023; 2023:6018736. [PMID: 37416623 PMCID: PMC10322534 DOI: 10.1155/2023/6018736] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/03/2023] [Accepted: 04/20/2023] [Indexed: 07/08/2023]
Abstract
Although proper pain evaluation is mandatory for establishing the appropriate therapy, self-reported pain level assessment has several limitations. Data-driven artificial intelligence (AI) methods can be employed for research on automatic pain assessment (APA). The goal is the development of objective, standardized, and generalizable instruments useful for pain assessment in different clinical contexts. The purpose of this article is to discuss the state of the art of research and perspectives on APA applications in both research and clinical scenarios. Principles of AI functioning will be addressed. For narrative purposes, AI-based methods are grouped into behavioral-based approaches and neurophysiology-based pain detection methods. Since pain is generally accompanied by spontaneous facial behaviors, several approaches for APA are based on image classification and feature extraction. Language features through natural language strategies, body postures, and respiratory-derived elements are other investigated behavioral-based approaches. Neurophysiology-based pain detection is obtained through electroencephalography, electromyography, electrodermal activity, and other biosignals. Recent approaches involve multimode strategies by combining behaviors with neurophysiological findings. Concerning methods, early studies were conducted by machine learning algorithms such as support vector machine, decision tree, and random forest classifiers. More recently, artificial neural networks such as convolutional and recurrent neural network algorithms are implemented, even in combination. Collaboration programs involving clinicians and computer scientists must be aimed at structuring and processing robust datasets that can be used in various settings, from acute to different chronic pain conditions. Finally, it is crucial to apply the concepts of explainability and ethics when examining AI applications for pain research and management.
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Affiliation(s)
- Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples 80131, Italy
| | - Daniela Schiavo
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples 80131, Italy
| | - Arturo Cuomo
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples 80131, Italy
| | - Alessandro Ottaiano
- SSD-Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori di Napoli IRCCS “G. Pascale”, Via M. Semmola, Naples 80131, Italy
| | - Francesco Perri
- Head and Neck Oncology Unit, Istituto Nazionale Tumori IRCCS-Fondazione “G. Pascale”, Naples 80131, Italy
| | - Renato Patrone
- Dieti Department, University of Naples, Naples, Italy
- Division of Hepatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS, Fondazione Pascale-IRCCS di Napoli, Naples, Italy
| | - Sara Migliarelli
- Department of Pharmacology, Faculty of Medicine and Psychology, University Sapienza of Rome, Rome, Italy
| | - Elena Giovanna Bignami
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Alessandro Vittori
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Rome 00165, Italy
| | - Francesco Cutugno
- Department of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples 80100, Italy
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Balasubramanian K, Prabu A, Shaik MF, Naik RA, Suguna SK. A hybrid deep learning for patient activity recognition (PAR): Real time body wearable sensor network from healthcare monitoring system (HMS). JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-212958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Today’s healthcare sectors are driven and work to rescue patients as soon as possible by giving them the right care and treatment. A healthcare monitoring system works in two ways: by keeping track of the patient’s activities and overall health. For prompt treatment, such as giving the right and suitable medication, administering an injection, and providing additional medical help, nursing supervision is required. Wearable sensors are fixed or connected to the patient’s body and can follow their health. These IoT medical gadgets let clinicians diagnose patients and comprehend the processes from remote. However, the amount of data produced by IoT devices is so large that it cannot be handled manually. A model for automated analysis is required. Convolution Neural Network with Long-Short Term Memory (CNN-LSTM) was therefore suggested in this study as a Hybrid Deep Learning Framework (HDLF) for a Patient Activity Monitoring System (PAMS) that brings all healthcare activities with its classes. To incorporate medical specialists from all over the world and enhance treatment outcomes, the framework offers an advanced model where patient activities, health conditions, medications, and other activities are distributed in the cloud. An effective architecture for Wearable Sensor Network-based Human Action Recognition that combines neural network Simple Recurrent Units (SRUs) and Gated Recurrent Units (GRUs). For assessing the multimodal data input sequence, deep SRUs and a variety of internal memory states is utilized in this research. Furthermore, for addressing the concerns about accuracy oscillations or instability with decreasing gradients, a deep GRUs to store and learn the knowledge is conveyed to the future state. The analysis suggests that CNN-LSTM is then contrasted with some of the currently used algorithms, and it is found that the new system has a 99.53% accuracy rate. The difference between this accuracy result and the current value is at least 4.73% .
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Affiliation(s)
- Kishore Balasubramanian
- Department of EEE, Dr. Mahalingam College of Engineering and Technology, Pollachi, Tamil Nadu, India
| | - A.V. Prabu
- Department of ECE, Koneru Lakshmaiah Education Foundation, Guntur, AP, India
| | - Mahammad Firose Shaik
- Department of EIE, Velagapudi Ramakrishna Siddhartha Engineering College, Vijayawada, AP, India
| | - R. Anjaneyulu Naik
- Department of EEE, Lakireddy Bali Reddy College of Engineering, Mylavaram, India
| | - S. Kanimozhi Suguna
- Department of Computer Science, Arasu College of Arts and Science for Women, Karur, India
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Xin X, Li X, Yang S, Lin X, Zheng X. Pain expression assessment based on a locality and identity aware network. IET IMAGE PROCESSING 2021; 15:2948-2958. [DOI: 10.1049/ipr2.12282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xuwu Xin
- The Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Xiaowu Li
- The Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Shengfu Yang
- The First Affiliated Hospital of Jinan University Guangzhou China
| | - Xiaoyan Lin
- The Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Xin Zheng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong Shantou China
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Li Y, Ghosh S, Joshi J. PLAAN: Pain Level Assessment with Anomaly-detection based Network. JOURNAL ON MULTIMODAL USER INTERFACES 2021; 15:359-372. [PMCID: PMC7786324 DOI: 10.1007/s12193-020-00362-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/17/2020] [Indexed: 06/18/2023]
Abstract
Automatic chronic pain assessment and pain intensity estimation has been attracting growing attention due to its widespread applications. One of the prevalent issues in automatic pain analysis is inadequate balanced expert-labelled data for pain estimation. This work proposes an anomaly detection based network addressing one of the existing limitations of automatic pain assessment. The evaluation of the network is performed on pain intensity estimation and protective behaviour estimation tasks from body movements in the EmoPain Challenge dataset. The EmoPain dataset consists of body part based sensor data for both the tasks. The proposed network, PLAAN (Pain Level Assessment with Anomaly-detection based Network), is a lightweight LSTM-DNN network which considers features based on sensor data as the input and predicts intensity level of pain and presence or absence of protective behaviour in chronic low back pain patients. Joint training considering body movement patterns, such as exercise type, corresponding to pain exhibition as a label improves the performance of the network. However, contrary to perception, protective behaviour rather exists sporadically alongside pain in the EmoPain dataset. This induces yet another complication in accurate estimation of protective behaviour. This problem is resolved by incorporating anomaly detection in the network. A detailed comparison of different networks with varied features is outlined in the paper, presenting a significant improvement with the final proposed anomaly detection based network.
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Affiliation(s)
- Yi Li
- Human Centered AI at Monash University, Melbourne, Australia
| | - Shreya Ghosh
- Human Centered AI at Monash University, Melbourne, Australia
| | - Jyoti Joshi
- Human Centered AI at Monash University, Melbourne, Australia
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