Personalized Deep Bi-LSTM RNN Based Model for Pain Intensity Classification Using EDA Signal

Uncertainty quantification in neural-network based pain intensity estimation

Improper pain management leads to severe physical or mental consequences, including suffering, a negative impact on quality of life, and an increased risk of opioid dependency. Assessing the presence and severity of pain is imperative to prevent such outcomes and determine the appropriate intervention. However, the evaluation of pain intensity is a challenging task because different individuals experience pain differently. To overcome this, many researchers in the field have employed machine learning models to evaluate pain intensity objectively using physiological signals. However, these efforts have primarily focused on pain point estimation, disregarding inherent uncertainty and variability in the data and model. A point estimate, which provides only partial information, is not sufficient for sound clinical decision-making. This study proposes a neural network-based method for objective pain interval estimation, and quantification of uncertainty. Our approach, which enables objective pain intensity estimation with desired confidence probabilities, affords clinicians a better understanding of a person's pain intensity. We explored three distinct algorithms: the bootstrap method, lower and upper bound estimation (LossL) optimized by genetic algorithm, and modified lower and upper bound estimation (LossS) optimized by gradient descent algorithm. Our empirical results demonstrate that LossS outperforms the other two by providing narrower prediction intervals. For 50%, 75%, 85%, and 95% prediction interval coverage probability, LossS provides average interval widths that are 22.4%, 7.9%, 16.7%, and 9.1% narrower than those of LossL, and 19.3%, 21.1%, 23.6%, and 26.9% narrower than those of bootstrap. As LossS outperforms, we assessed its performance in three different model-building approaches: (1) a generalized approach using a single model for the entire population, (2) a personalized approach with separate models for each individual, and (3) a hybrid approach with models for clusters of individuals. Results demonstrate that the hybrid model-building approach provides the best performance.

Non-Invasive Biosensing for Healthcare Using Artificial Intelligence: A Semi-Systematic Review

The rapid development of biosensing technologies together with the advent of deep learning has marked an era in healthcare and biomedical research where widespread devices like smartphones, smartwatches, and health-specific technologies have the potential to facilitate remote and accessible diagnosis, monitoring, and adaptive therapy in a naturalistic environment. This systematic review focuses on the impact of combining multiple biosensing techniques with deep learning algorithms and the application of these models to healthcare. We explore the key areas that researchers and engineers must consider when developing a deep learning model for biosensing: the data modality, the model architecture, and the real-world use case for the model. We also discuss key ongoing challenges and potential future directions for research in this field. We aim to provide useful insights for researchers who seek to use intelligent biosensing to advance precision healthcare.

Transformer encoder with multiscale deep learning for pain classification using physiological signals

Pain, a pervasive global health concern, affects a large segment of population worldwide. Accurate pain assessment remains a challenge due to the limitations of conventional self-report scales, which often yield inconsistent results and are susceptible to bias. Recognizing this gap, our study introduces PainAttnNet, a novel deep-learning model designed for precise pain intensity classification using physiological signals. We investigate whether PainAttnNet would outperform existing models in capturing temporal dependencies. The model integrates multiscale convolutional networks, squeeze-and-excitation residual networks, and a transformer encoder block. This integration is pivotal for extracting robust features across multiple time windows, emphasizing feature interdependencies, and enhancing temporal dependency analysis. Evaluation of PainAttnNet on the BioVid heat pain dataset confirm the model's superior performance over the existing models. The results establish PainAttnNet as a promising tool for automating and refining pain assessments. Our research not only introduces a novel computational approach but also sets the stage for more individualized and accurate pain assessment and management in the future.

Analysis of pain research literature through keyword Co-occurrence networks

Pain is a significant public health problem as the number of individuals with a history of pain globally keeps growing. In response, many synergistic research areas have been coming together to address pain-related issues. This work reviews and analyzes a vast body of pain-related literature using the keyword co-occurrence network (KCN) methodology. In this method, a set of KCNs is constructed by treating keywords as nodes and the co-occurrence of keywords as links between the nodes. Since keywords represent the knowledge components of research articles, analysis of KCNs will reveal the knowledge structure and research trends in the literature. This study extracted and analyzed keywords from 264,560 pain-related research articles indexed in IEEE, PubMed, Engineering Village, and Web of Science published between 2002 and 2021. We observed rapid growth in pain literature in the last two decades: the number of articles has grown nearly threefold, and the number of keywords has grown by a factor of 7. We identified emerging and declining research trends in sensors/methods, biomedical, and treatment tracks. We also extracted the most frequently co-occurring keyword pairs and clusters to help researchers recognize the synergies among different pain-related topics.

Design and Evaluation of Deep Learning Models for Continuous Acute Pain Detection Based on Phasic Electrodermal Activity

The current method for assessing pain in clinical practice is subjective and relies on self-reported scales. An objective and accurate method of pain assessment is needed for physicians to prescribe the proper medication dosage, which could reduce addiction to opioids. Hence, many works have used electrodermal activity (EDA) as a suitable signal for detecting pain. Previous studies have used machine learning and deep learning to detect pain responses, but none have used a sequence-to-sequence deep learning approach to continuously detect acute pain from EDA signals, as well as accurate detection of pain onset. In this study, we evaluated deep learning models including 1-dimensional convolutional neural networks (1D-CNN), long short-term memory networks (LSTM), and three hybrid CNN-LSTM architectures for continuous pain detection using phasic EDA features. We used a database consisting of 36 healthy volunteers who underwent pain stimuli induced by a thermal grill. We extracted the phasic component, phasic drivers, and time-frequency spectrum of the phasic EDA (TFS-phEDA), which was found to be the most discerning physiomarker. The best model was a parallel hybrid architecture of a temporal convolutional neural network and a stacked bi-directional and uni-directional LSTM, which obtained a F1-score of 77.8% and was able to correctly detect pain in 15-second signals. The model was evaluated using 37 independent subjects from the BioVid Heat Pain Database and outperformed other approaches in recognizing higher pain levels compared to baseline with an accuracy of 91.5%. The results show the feasibility of continuous pain detection using deep learning and EDA.

Artificial Intelligence for Automatic Pain Assessment: Research Methods and Perspectives

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.

Machine Learning Analysis of RNA-seq Data for Diagnostic and Prognostic Prediction of Colon Cancer

Data from omics studies have been used for prediction and classification of various diseases in biomedical and bioinformatics research. In recent years, Machine Learning (ML) algorithms have been used in many different fields related to healthcare systems, especially for disease prediction and classification tasks. Integration of molecular omics data with ML algorithms has offered a great opportunity to evaluate clinical data. RNA sequence (RNA-seq) analysis has been emerged as the gold standard for transcriptomics analysis. Currently, it is being used widely in clinical research. In our present work, RNA-seq data of extracellular vesicles (EV) from healthy and colon cancer patients are analyzed. Our aim is to develop models for prediction and classification of colon cancer stages. Five different canonical ML and Deep Learning (DL) classifiers are used to predict colon cancer of an individual with processed RNA-seq data. The classes of data are formed on the basis of both colon cancer stages and cancer presence (healthy or cancer). The canonical ML classifiers, which are k-Nearest Neighbor (kNN), Logistic Model Tree (LMT), Random Tree (RT), Random Committee (RC), and Random Forest (RF), are tested with both forms of the data. In addition, to compare the performance with canonical ML models, One-Dimensional Convolutional Neural Network (1-D CNN), Long Short-Term Memory (LSTM), and Bidirectional LSTM (BiLSTM) DL models are utilized. Hyper-parameter optimizations of DL models are constructed by using genetic meta-heuristic optimization algorithm (GA). The best accuracy in cancer prediction is obtained with RC, LMT, and RF canonical ML algorithms as 97.33%. However, RT and kNN show 95.33% performance. The best accuracy in cancer stage classification is achieved with RF as 97.33%. This result is followed by LMT, RC, kNN, and RT with 96.33%, 96%, 94.66%, and 94%, respectively. According to the results of the experiments with DL algorithms, the best accuracy in cancer prediction is obtained with 1-D CNN as 97.67%. BiLSTM and LSTM show 94.33% and 93.67% performance, respectively. In classification of the cancer stages, the best accuracy is achieved with BiLSTM as 98%. 1-D CNN and LSTM show 97% and 94.33% performance, respectively. The results reveal that both canonical ML and DL models may outperform each other for different numbers of features.