It can be hard to get a straight answer from a two-year old. “What did Daddy give you?” “I don’t know.” “How old are you?” “5!”, “This much!”, “Do you like the park?” “Maybe”. So how can you tell if your child is receiving the right amount of treatment for pain management, in the hospital?
You can’t. Unfortunately, often children who are admitted for care can’t express the full range of their emotions, and the amount of pain treatment they need is underestimated by hospital staff.
A disturbing report by NBC earlier this year told of the bias in place in many hospitals, where black kids are receiving less pain medication than white kids suffering from the same serious conditions in the ER.
But a new study is changing that. By using software to detect pain levels in children’s faces, rather than asking them how they feel or asking nurses to guess for them, it is being shown that the bias in treatment can be eliminated.
The study, which used novel facial pattern recognition software to read pediatric faces, was done by researchers at the University of California, San Diego School of Medicine. And results proved useful.
“The current gold standard for measuring pain is self-reporting, (asking patients to rate their pain on a scale of zero to 10),” said senior author Jeannie Huang, MD, MPH, a professor in the UC San Diego School of Medicine Department of Pediatrics and a gastroenterologist at Rady Children’s Hospital-San Diego. “But in pediatrics there is a limited population of kids who can answer that question in a meaningful way. Younger children can have difficulty- a two-year-old hasn’t developed the cognitive and conceptual abilities to think in those terms.”
And, as mentioned, nurses can underestimate pain management needs when asked to guess for children, and parents, Huang noted, while more in tune with their kids, aren’t always available in the right moment.
Controlling pain, the researchers stated, is an important part of assuring a child recovers well from surgery. Not treating it enough, studies have shown, is associated with problem surgical outcomes.
So what was done in the study? The software used analyzed pain-related facial expressions from videos taken of 50 kids, from five to 18 years old, who had undergone surgery to have their appendix removed.
Researchers used clinical data gathered by the study team and pain level scores for each patient, obtained from the software readings to determine what level of pain management was needed.
“The software demonstrated good-to-excellent accuracy in assessing pain conditions,” said Huang. “Overall, this technology performed equivalent to parents and better than nurses. It also showed strong correlations with patient self-reported pain ratings.”
And not only is the software unbiased in its readings of children’s faces and didn’t discriminated by ethnicity, race, gender, or age, but it has another benefit-it can also operate continuously in real time. This means that if a patient is experiencing pain at a time different than when the nurses usually come around to record pain levels, staff can be alerted and the pain can be treated, in a timely way.
Sounds like the wave of the future.
More work still needs to be done before this software is a mainstay for treating children in hospitals, Huang says, but it looks like a good beginning for approaching painful situations in a new way.