Yasamin Zarghami

Y. Zarghami, S. Mafeld, A. Conway et al.

Pain monitoring is essential to the quality of care for patients undergoing a medical procedure with sedation. An automated mechanism for detecting pain could improve sedation dose titration. Previous studies on facial pain detection have shown the viability of computer vision methods in detecting pain in unoccluded faces. However, the faces of patients undergoing procedures are often partially occluded by medical devices and face masks. A previous preliminary study on pain detection on artificially occluded faces has shown a feasible approach to detect pain from a narrow band around the eyes. This study has collected video data from masked faces of 14 patients undergoing procedures in an interventional radiology department and has trained a deep learning model using this dataset. The model was able to detect expressions of pain accurately and, after causal temporal smoothing, achieved an average precision (AP) of 0.72 and an area under the receiver operating characteristic curve (AUC) of 0.82. These results outperform baseline models and show viability of computer vision approaches for pain detection of masked faces during procedural sedation. Cross-dataset performance is also examined when a model is trained on a publicly available dataset and tested on the sedation videos. The ways in which pain expressions differ in the two datasets are qualitatively examined.

Babak Taati, Muhammad Muzammil, Yasamin Zarghami et al. · utoronto

Accurate pain assessment in patients with limited ability to communicate, such as older adults with dementia, represents a critical healthcare challenge. Robust automated systems of pain detection may facilitate such assessments. Existing pain detection datasets, however, suffer from limited ethnic/racial diversity, privacy constraints, and underrepresentation of older adults who are the primary target population for clinical deployment. We present SynPAIN, a large-scale synthetic dataset containing 10,710 facial expression images (5,355 neutral/expressive pairs) across five ethnicities/races, two age groups (young: 20-35, old: 75+), and two genders. Using commercial generative AI tools, we created demographically balanced synthetic identities with clinically meaningful pain expressions. Our validation demonstrates that synthetic pain expressions exhibit expected pain patterns, scoring significantly higher than neutral and non-pain expressions using clinically validated pain assessment tools based on facial action unit analysis. We experimentally demonstrate SynPAIN's utility in identifying algorithmic bias in existing pain detection models. Through comprehensive bias evaluation, we reveal substantial performance disparities across demographic characteristics. These performance disparities were previously undetectable with smaller, less diverse datasets. Furthermore, we demonstrate that age-matched synthetic data augmentation improves pain detection performance on real clinical data, achieving a 7.0% improvement in average precision. SynPAIN addresses critical gaps in pain assessment research by providing the first publicly available, demographically diverse synthetic dataset specifically designed for older adult pain detection, while establishing a framework for measuring and mitigating algorithmic bias. The dataset is available at https://doi.org/10.5683/SP3/WCXMAP