Application of AI in Multilevel Pain Assessment Using Facial Images: Systematic Review and Meta-Analysis

Huo, Jian1; Yu, Yan2; Lin, Wei3; Hu, Anmin2,3,4; Wu, Chaoran2

2024-04-12

10.2196/51250

JOURNAL OF MEDICAL INTERNET RESEARCH   影响因子和分区

1438-8871

Background: The continuous monitoring and recording of patients' pain status is a major problem in current research on postoperative pain management. In the large number of original or review articles focusing on different approaches for pain assessment, many researchers have investigated how computer vision (CV) can help by capturing facial expressions. However, there is a lack of proper comparison of results between studies to identify current research gaps. Objective: The purpose of this systematic review and meta-analysis was to investigate the diagnostic performance of artificial intelligence models for multilevel pain assessment from facial images. Methods: The PubMed, Embase, IEEE, Web of Science, and Cochrane Library databases were searched for related publications before September 30, 2023. Studies that used facial images alone to estimate multiple pain values were included in the systematic review. A study quality assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies, 2nd edition tool. The performance of these studies was assessed by metrics including sensitivity, specificity, log diagnostic odds ratio (LDOR), and area under the curve (AUC). The intermodal variability was assessed and presented by forest plots. Results: A total of 45 reports were included in the systematic review. The reported test accuracies ranged from 0.27-0.99, and the other metrics, including the mean standard error (MSE), mean absolute error (MAE), intraclass correlation coefficient (ICC), and Pearson correlation coefficient (PCC), ranged from 0.31-4.61, 0.24-2.8, 0.19-0.83, and 0.48-0.92, respectively. In total, 6 studies were included in the meta-analysis. Their combined sensitivity was 98% (95% CI 96%-99%), specificity was 98% (95% CI 97%-99%), LDOR was 7.99 (95% CI 6.73-9.31), and AUC was 0.99 (95% CI 0.99-1). The subgroup analysis showed that the diagnostic performance was acceptable, although imbalanced data were still emphasized as a major problem. All studies had at least one domain with a high risk of bias, and for 20% (9/45) of studies, there were no applicability concerns. Conclusions: This review summarizes recent evidence in automatic multilevel pain estimation from facial expressions and compared the test accuracy of results in a meta-analysis. Promising performance for pain estimation from facial images was established by current CV algorithms. Weaknesses in current studies were also identified, suggesting that larger databases and metrics evaluating multiclass classification performance could improve future studies.

computer vision facial image monitoring multilevel pain assessment pain postoperative status

SCI

英语

通讯

Health Care Sciences & Services ; Medical Informatics

Health Care Sciences & Services ; Medical Informatics

WOS:001221403000001

JMIR PUBLICATIONS, INC

CLINICAL MEDICINE

Web of Science

1.Shenzhen United Scheme Technol Co Ltd, Boston Intelligent Med Res Ctr, Boston, MA USA
2.Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Dept Anesthesia, Shenzhen Key Med Discipline,Affiliated Hosp 1, 1017 Dongmen North Rd, Shenzhen 518020, Peoples R China
3.Shenzhen United Scheme Technol Co Ltd, Shenzhen, Peoples R China
4.Jinan Univ, Clin Med Coll 2, Shenzhen, Peoples R China

Huo, Jian,Yu, Yan,Lin, Wei,et al. Application of AI in Multilevel Pain Assessment Using Facial Images: Systematic Review and Meta-Analysis[J]. JOURNAL OF MEDICAL INTERNET RESEARCH,2024,26.

Huo, Jian,Yu, Yan,Lin, Wei,Hu, Anmin,&Wu, Chaoran.(2024).Application of AI in Multilevel Pain Assessment Using Facial Images: Systematic Review and Meta-Analysis.JOURNAL OF MEDICAL INTERNET RESEARCH,26.

Huo, Jian,et al."Application of AI in Multilevel Pain Assessment Using Facial Images: Systematic Review and Meta-Analysis".JOURNAL OF MEDICAL INTERNET RESEARCH 26(2024).