Relevance Vector Machine Learning for Neonate Pain Intensity Assessment Using Digital Imaging

Pain assessment in patients who are unable to verbally communicate is a challenging problem. The fundamental limitations in pain assessment in neonates stem from subjective assessment criteria, rather than quantifiable and measurable data. This often results in poor quality and inconsistent treatment of patient pain management. Recent advancements in pattern recognition techniques using relevance vector machine (RVM) learning techniques can assist medical staff in assessing pain by constantly monitoring the patient and providing the clinician with quantifiable data for pain management. The RVM classification technique is a Bayesian extension of the support vector machine (SVM) algorithm, which achieves comparable performance to SVM while providing posterior probabilities for class memberships and a sparser model. If classes represent “pure” facial expressions (i.e., extreme expressions that an observer can identify with a high degree of confidence), then the posterior probability of the membership of some intermediate facial expression to a class can provide an estimate of the intensity of such an expression. In this paper, we use the RVM classification technique to distinguish pain from nonpain in neonates as well as assess their pain intensity levels. We also correlate our results with the pain intensity assessed by expert and nonexpert human examiners.

[1]  K. Craig,et al.  A theoretical framework for understanding self-report and observational measures of pain: a communications model. , 2002, Behaviour research and therapy.

[2]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[3]  Heekuck Oh,et al.  Neural Networks for Pattern Recognition , 1993, Adv. Comput..

[4]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[5]  Jean-Luc Bosson,et al.  Assessing pain in critically ill sedated patients by using a behavioral pain scale , 2001, Critical care medicine.

[6]  Amine Ali Zeggwagh,et al.  Validation of a Behavioral Pain Scale in Critically Ill, Sedated, and Mechanically Ventilated Patients , 2005, Anesthesia and analgesia.

[7]  Jacob Cohen,et al.  Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. , 1968 .

[8]  Naiji Lu,et al.  Neonatal pain facial expression: Evaluating the primal face of pain , 2008, PAIN.

[9]  R. Redi [FACIAL EXPRESSION IN PAIN]. , 1965, Rassegna clinico-scientifica.

[10]  B. Stevens,et al.  Premature Infant Pain Profile: development and initial validation. , 1996, The Clinical journal of pain.

[11]  C. Gross,et al.  Sedating critically ill patients: factors affecting nurses' delivery of sedative therapy. , 2001, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[12]  Sheryl Brahnam,et al.  Machine recognition and representation of neonatal facial displays of acute pain , 2006, Artif. Intell. Medicine.

[13]  Sheryl Brahnam,et al.  Machine assessment of neonatal facial expressions of acute pain , 2007, Decis. Support Syst..

[14]  Céline Gélinas,et al.  Pain assessment and management in critically ill intubated patients: a retrospective study. , 2004, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[15]  家田 由美子,et al.  人工呼吸症例に対するRichmond Agitation Sedation Scaleの導入 , 2009 .

[16]  K. Prkachin Assessing pain by facial expression: facial expression as nexus. , 2009, Pain research & management.

[17]  Vladimir N. Vapnik,et al.  The Nature of Statistical Learning Theory , 2000, Statistics for Engineering and Information Science.

[18]  Radford M. Neal Pattern Recognition and Machine Learning , 2007, Technometrics.

[19]  David J. C. MacKay,et al.  Bayesian Interpolation , 1992, Neural Computation.

[20]  C. Sessler,et al.  The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. , 2002, American journal of respiratory and critical care medicine.

[21]  Loris Nanni,et al.  Introduction to Neonatal Facial Pain Detection Using Common and Advanced Face Classification Techniques , 2007, Advanced Computational Intelligence Paradigms in Healthcare.

[22]  K. Craig,et al.  A comparison of two measures of facial activity during pain in the newborn child. , 1994, Journal of pediatric psychology.

[23]  J. Berger Statistical Decision Theory and Bayesian Analysis , 1988 .

[24]  Jacob Cohen A Coefficient of Agreement for Nominal Scales , 1960 .

[25]  D R Nerenz,et al.  Motor Activity Assessment Scale: a valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit. , 1999, Critical care medicine.

[26]  George Eastman House,et al.  Sparse Bayesian Learning and the Relevan e Ve tor Ma hine , 2001 .

[27]  Loris Nanni,et al.  Neonatal Facial Pain Detection Using NNSOA and LSVM , 2008, IPCV.

[28]  Brian Everitt,et al.  Statistical Methods for Medical Investigations , 1990 .

[29]  D. Feeny,et al.  Does it matter whom and how you ask? inter- and intra-rater agreement in the Ontario Health Survey. , 1997, Journal of clinical epidemiology.

[30]  T. Voepel-Lewis,et al.  The FLACC: a behavioral scale for scoring postoperative pain in young children. , 1997, Pediatric nursing.

[31]  Bart Vanrumste,et al.  Image Acquisition System to Monitor Discomfort in Demented Elderly Patients , 2007 .

[32]  James M Bailey,et al.  Closed-loop control for intensive care unit sedation. , 2009, Best practice & research. Clinical anaesthesiology.

[33]  Christopher E. Hann,et al.  Measuring facial grimacing for quantifying patient agitation in critical care , 2007, Comput. Methods Programs Biomed..