Abstract
objective measurement of subjective, multi-dimensionally experienced pain is a problem for which there has not been an adequate solution. Although verbal methods (e.g., pain scales and questionnaires) are commonly used to measure clinical pain, they tend to lack objectivity, reliability, or validity when applied to mentally impaired individuals. Biopotential and behavioral parameters may represent a solution. Such coding systems already exist, but they are either very costly or time-consuming or have not been sufficiently evaluated. In this context, we collected a database of biopotentials to advance an automated pain recognition system, determine its theoretical testing quality, and optimize its performance. For this purpose, participants were subjected to painful heat stimuli under controlled conditions. One hundred thirty-five features were extracted from the mathematical groupings of amplitude, frequency, stationarity, entropy, linearity, and variability. The following features were chosen as the most selective: (1) electromyography corrugator peak to peak, (2) corrugator shannon entropy, and (3) heart rate variability slope RR. Individual-specific calibration allows the adjustment of feature patterns, resulting in significantly more accurate pain detection rates. The objective measurement of pain in patients will provide valuable information for the clinical team, which may aid the objective assessment of treatment (e.g., effectiveness of drugs for pain reduction, information on surgical indication, and quality of care provided to patients).
Highlights
Pain is a very personal sensation that is difficult to interpret without any communication from the patient
We have presented a newly collected multimodal dataset (BioVid Heat Pain Database; Walter, 2013a) to facilitate advances in the reliable recognition of pain intensity
Valid recognition of pain in infants, people who suffer from dementia, and people with limited verbal communication skills
Summary
Pain is a very personal sensation that is difficult to interpret without any communication from the patient. A method for the objective measurement of pain would be beneficial, in cases in which the patient is unable to describe the pain that he or she is experiencing, such as in neonates (Brahnam, Chuang, Shih, & Slack, 2006), somnolent patients, and patients who suffer from dementia (Basler et al, 2001; Zwakhalen, Hamers, Abu-Saad, & Berger, 2006; Herr, Bjoro & Decker, 2006). Little correlation exists between subjectively experienced pain and tissue lesions or other pathological changes. Somatic pathology does not allow any conclusions to be drawn about subjectively experienced pain (Turk & Okifuji, 1999; Nilges & Traue, 2007). Older individuals, and patients who suffer from dementia have different pain thresholds and varying tolerance to pain relative to healthy adults (Lautenbacher, 2004; Soetanto, Chung, & Wong, 2004)
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