Artificial Intelligence for Automatic Pain Assessment: Research Methods and Perspectives.

Journal: Pain research & management
Published Date:

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.

Authors

  • Marco Cascella
    Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, 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.
  • 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, Piazza S. Onofrio 4, 00165, Rome, Italy.
  • Francesco Cutugno
    Department of Electrical Engineering and Information Technologies, University of Naples "Federico II", Naples 80100, Italy.