Artificial intelligence to fight the ‘monster’ of pain

and health

A young Catalan researcher has developed a facial recognition system that detects suffering, something that could help the diagnosis of one of the evils that accumulates the most medical consultations

Lorena Ferro

Barcelona

“Pain is a monster.A giant that nobody wants to take for the horns. ”The definition is from Christian Dürsteler, anesthesiologist who deals daily with ailments of all kinds because he is the head of the Pain Unit of the Clinic Hospital of Barcelona.To help fight that evil, Pau Rodríguez, a young Catalan computer scientist who investigates from Canada, has created a system that through artificial intelligence (AI) is able to detect human pain with great precision.The algorithm opens the field to a more effective diagnosis of pain.Pau and Christian are not known personally, but from one from Canada and the other from Barcelona and in different areas- that of computer science and medicine- work to improve the health problem most reported in health surveys.

Rodríguez's algorithm, which has received one of the young computer awards granted by Computer Lacientific from Spain (SCIE) and the BBVA Foundation, is based on learning with artificial neural networks that “are inspired by how the brain incorporates new knowledge fromto modify the connections between neurons. ”This young researcher - formed in Spanish public education - and his team achieved that one of these networks learned to "associate facial videos of patients with the corresponding pain level they experienced with rehabilitation exercises."

The system could detect pain very precisely.And not only that, but it was also able to distinguish in most occasions if the pain was fake thanks to the introduction of the information of a control group that made grimaces "without feeling any pain."Pau Rodríguez believes that the algorithm "learned to detect involuntary gestures and ignore the rest of facial movements."

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The application in medicine

Detect pain more precisely

"Pau's application could solve some real world problems," explains Dr. Dürsteler from Barcelona. In the unit of which he is visible head, they treat patients with acute pain, high complexity such as cancer patients and also many cases of chronic pain. And the vast majority of the derivations they receive have muscoloeskehly pain produced by osteoarthritis or by discgenerative pathologies. This anesthesiologist thinks that systems such as Rodriguez could greatly facilitate the task of knowing if patient imposed treatment is working. Actually, Dürsteler continues, the method of this young scientist is not new. He remembers that decades ago a neonatologist and a nurse designed a faces scale to try to "guess" the intensity of pain. But the technology applied by Pau Rodríguez seems more precise. And it is that the systems based on AI such as Rodríguez, who explains that it is available in open source and has already served as the basis of more than 200 studies, "are able to detect more subtle signs than a human."

Using the algorithm of this young computer scientist, a hospital in Nice managed to predict dementia after observing the patient's gestures, explains the researcher.And another use that could be the algorithm, Rodriguez points out, would be in the intensive care units of the hospitals in which “a sanitary must go to verify if the person is suffering” to decide thus if the medication should be raised.Rodríguez, a researcher at Servicenow, attached professor at the Autonoma Unjversitat of Barcelona (UAB) and doctor in computer science, also considers that having an “objective method to warn that you are suffering pain, also reduces the patient's waiting time”.

But can systems such as the one designed by the Catalan computer scientist to end up replacing the doctor?Christian Dürsteler warns that AI already threatens for example to radiologists because "a computer today can diagnose skin cancer with the same accuracy or more than a pathologist."In addition, the algorithm never tires, he explains.Despite this, he positively values that the technology "can download us from the mechanical" to work with patients.

The ethical debate

A system that requires patient information

But not everything is flowers for a system, that of AI, which requires a lot of information to be effective.And this is where the ethical debate opens.And it is that precise systems such as Rodríguez need clinical data and a lot of patient information to cross them.And the danger is that these are confidential data that the "pharmaceutical industry" shows great interest in achieving, says Dürsteler;something that is "highly worrying."Therefore, he believes you have to analyze "well" how the system is used and develop.

Rodríguez says that the ethical debate "is very present in the scientific community" despite recognizing that as any scientific advance AI can have a positive impact on our lives, but in the same way it is used with "negative purposes."In this sense, the scientist values that science has improved the quality of life of most of humanity and believes that AI will "accelerate this progress."In addition, he explains that now he is immersed in developing a computational learning algorithm that needs less data to learn.

Sensory and emotional

The difficult definition of what pain is?

Defining the concept of pain is not an easy task, explains the head of the Pain Unit of the Clinic, which details that we could talk about “an unpleasant sensory and emotional experience that seems to be associated with the injury of a real or potential fabric”.And it is that the pain always has an "necessary" affective load for the evolution of the species, explains DürsTeler setting the example of the child who burns with a flame and never burn again thanks to the "emotional" part of memory.Even so, there is no quantification of the weight that emotion has in pain because it varies according to people.What is known is that emotion weighs less in acute pain as a surgery or an accident, but is much more predominant in chronic pain.And these are, explains the anesthetist, the bulk of patients who attend in the pain unit that he captains.

It is precisely in this pain associated with an emotion where AI can have more exit.And what uses can be given?DürsTeler sets an example: filming the medical interview with a patient to know the level of pain she has and on an upcoming visit to be able to check "if she has improved."Currently, in the clinic pain unit they do not use technology, nor the one implemented by the Catalan computer scientist or any other, although the prediction that will soon be “an hatching” of this type of systems that will also measure the pain by the voice.However, DürsTeler claims the role of the optional because the algorithms will not say how they have come to that conclusion.

Chronic pain, the great forgotten in health

In addition to directing the pain unit, Christian Dürsteler, coordinates a subject of pain treatment for medical students. An area, that of pain, in which he says that there is a serious training problem and that it is the main cause of work leave. DürsTeler claims that the pain "is the great forgotten because it is believed that it does not kill" although in reality it does because it causes people who suffer from "live less years." That is why he warns that he must be heard and taken into account in health plans. The doctor warns that between 20 and 30% of patients have chronic pain and that it is this type of evil that most care in unity with chronic low back pain, osteoarthritis or cervicalgia as more common evils. And the way of approaching pain is different depending on evil. In the high complexity such as that produced by cancer, infiltrations or morphine implants will be necessary. But there are many other types of pain, such as low back pain or other neurodegenerative evils, which have a less pharmacological approach - of which he thinks he often abuses - and more multiprofesional. In these areas, rehabilitation and psychological attention are also very important. Also the directed physical exercise. Everything to age with "a certain quality." It is one of the challenges of the future that has health, he assures.