Assessment of Postoperative Pain in Children With Facial Expression Analysis

Study Overview
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Brief Summary
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The present study was conducted to evaluate the use of computer-aided facial expression analysis to assess postoperative pain in children. The study population consisted of patients in the age group of 7-18 years who underwent surgery at Bursa Uludağ University Faculty of Medicine Health Application and Research Hospital Pediatric Surgery Clinic between November 2019 and June 2021. The sample of the study consisted of total 83 children who agreed to participate in the study and who met the sample selection criteria. Data were collected by the researcher using the Wong Baker Faces (WBS) pain rating scale and Visual Analog Scale (VAS). Data were collected from the child, mother, nurse, and one external observer. Facial action units associated with pain were used for machine estimation. OpenFace was used to analyze the child's facial action units and Python was used for machine learning algorithms. Intraclass correlation coefficient, Kappa coefficient, and linear regression analysis were used for statistical analysis of the data. The pain score predicted by the machine and the pain score assessments of the child, mother, nurse, and observer were compared.

Official Title
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Assessment of Postoperative Pain in Children With Computer Assisted Facial Expression Analysis

Conditions
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Pain, Postoperative

Intervention / Treatment
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* Other: The facial expressions analyzed


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient is awake and oriented after the surgery, The patient must be within the first 12 hours after the operation and not be discharged before the first 36 hours after the operation, The patient is between the ages of 7-18, It is the mother's staying with the patient as a companion. Exclusion Criteria: Presence of any facial anomalies that may alter facial expression analysis, The patient has neurological and mental disorders, Having regular opiate use in the last 6 months, These are surgical procedures that require the patient to be in a prone position.

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pain assessments<br>In the study, primarily the pain assessment data of children were collected. In these pain assessments, assessments of the child, mother, nurse and an independent observer were taken. Simultaneously, a video recording of the child's facial expressions was made. | Other: The facial expressions analyzed<br>* The facial expressions associated with pain were analyzed by the researchers in the OpenFace program. The patient's pain scores were estimated in the Python program by combining the numerical outputs of facial expression analyses with machine learning algorithms.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the first observation on pain assessment of children by human | WBS scales were used for pain assessment of children, mothers, nurses, and observers. | after surgery in the first 12 hours | 
| the first observation on pain assessment of children by human | VAS scales were used for pain assessment of children, mothers, nurses, and observers. | after surgery in the first 12 hours | 
| the second observation on pain assessment of children by human | VAS scales were used for pain assessment of children, mothers, nurses, and observers. | after surgery 24.-36. range hours | 
| the second observation on pain assessment of children by human | WBS scales were used for pain assessment of children, mothers, nurses, and observers. | after surgery 24.-36. range hours | 
| child's facial expressions | Facial action units associated with pain were used from the camera recordings of the child's facial expressions. | up to the first 36 hours. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain assessment of children by machine | machine-estimated pain severity score from facial expression analysis. | up to the first 36 hours. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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children, facial expression analysis, machine learning, pain assessment