Automatic continuous time, continuous value assessment of a patient's pain from face video is highly sought after by the medical profession. Despite the recent advances in deep learning that attain impressive results in many domains, pain estimation risks not being able to benefit from this due to the difficulty in obtaining data sets of considerable size. In this work we propose a combination of hand-crafted and deep-learned features that makes the most of deep learning techniques in small sample settings. Encoding shape, appearance, and dynamics, our method significantly outperforms the current state of the art, attaining a RMSE error of less than 1 point on a 16-level pain scale, whilst simultaneously scoring a 67.3 Pearson correlation coefficient between our predicted pain level time series and the ground truth.
Attempts have also been made to combine visual features with physiological signals in @cite_26 . Their findings show that using combined data sources yields better performance than individual sources. However, rather than pain intensity estimation, only a pair wise pain classification was achieved for the four pain levels contained in the Bio-vid pain database.
@cite_26
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Pain is what the patient says it is. But what about these who cannot utter? Automatic pain monitoring opens up prospects for better treatment, but accurate assessment of pain is challenging due to the subjective nature of pain. To facilitate advances, we contribute a new dataset, the BioVid Heat Pain Database which contains videos and physiological data of 90 persons subjected to well-defined pain stimuli of 4 intensities. We propose a fully automatic recognition system utilizing facial expression, head pose information and their dynamics. The approach is evaluated with the task of pain detection on the new dataset, also outlining open challenges for pain monitoring in general. Additionally, we analyze the relevance of head pose information for pain recognition and compare person-specific and general classification models. Pain is typically assessed by patient self-report. Self-reported pain, however, is difficult to interpret and may be impaired or in some circumstances (i.e., young children and the severely ill) not even possible. To circumvent these problems behavioral scientists have identified reliable and valid facial indicators of pain. Hitherto, these methods have required manual measurement by highly skilled human observers. In this paper we explore an approach for automatically recognizing acute pain without the need for human observers. Specifically, our study was restricted to automatically detecting pain in adult patients with rotator cuff injuries. The system employed video input of the patients as they moved their affected and unaffected shoulder. Two types of ground truth were considered. Sequence-level ground truth consisted of Likert-type ratings by skilled observers. Frame-level ground truth was calculated from presence absence and intensity of facial actions previously associated with pain. Active appearance models (AAM) were used to decouple shape and appearance in the digitized face images. Support vector machines (SVM) were compared for several representations from the AAM and of ground truth of varying granularity. We explored two questions pertinent to the construction, design and development of automatic pain detection systems. First, at what level (i.e., sequence- or frame-level) should datasets be labeled in order to obtain satisfactory automatic pain detection performance? Second, how important is it, at both levels of labeling, that we non-rigidly register the face? Although it is well known that pain induces changes in autonomic parameters, the extent to which these changes correlate with the experience of pain is under debate. The aim of the present study was to compare a combination of multiple autonomic parameters and each parameter alone in their ability to differentiate among 4 categories of pain intensity. Tonic heat stimuli (1 minute) were individually adjusted to induce no pain, low, medium, and high pain in 45 healthy volunteers. Electrocardiogram, photoplethysmogram, and galvanic skin response were recorded, and the following parameters were calculated: heart rate; heart rate variability—high frequency (0.15 to 0.4 Hz) spectral power; skin conductance level; number of skin conduction fluctuations; and photoplethysmographic pulse wave amplitude. A combination of parameters was created by fitting an ordinal cumulative logit model to the data and using linear coefficients of the model. Friedman test with post-hoc Wilcoxon test were used to compare between pain intensity categories for every parameter alone and for their linear combination. All of the parameters successfully differentiated between no pain and all other pain categories. However, none of the parameters differentiated between all 3 pain categories (i.e., low and medium; medium and high; low and high). In contrast, the linear combination of parameters significantly differentiated not only between pain and no pain, but also between all pain categories (P < .001 to .02). These results suggest that multiparameter approaches should be further investigated to make progress toward reliable autonomic-based pain assessment. How much does it hurt? Accurate assessment of pain is very important for selecting the right treatment, however current methods are not sufficiently valid and reliable in many cases. Automatic pain monitoring may help by providing an objective and continuous assessment. In this paper we propose an automatic pain recognition system combining information from video and biomedical signals, namely facial expression, head movement, galvanic skin response, electromyography and electrocardiogram. Using the BioVid Heat Pain Database, the system is evaluated in the task of pain detection showing significant improvement over the current state of the art. Further, we discuss the relevance of the modalities and compare person-specific and generic classification models.