Infants\u27 Pain Recognition Based on Facial Expression: Dynamic Hybrid Descriptions

Abstract The accurate assessment of infants\u27 pain is important for understanding their medical conditions and developing suitable treatment. Pediatric studies reported that the inadequate treatment of infants\u27 pain might cause various neuroanatomical and psychological problems. The fact that infants can not communicate verbally motivates increasing interests to develop automatic pain assessment system that provides continuous and accurate pain assessment. In this paper, we propose a new set of pain facial activity features to describe the infants\u27 facial expression of pain. Both dynamic facial texture feature and dynamic geometric feature are extracted from video sequences and utilized to classify facial expression of infants as pain or no pain. For the dynamic analysis of facial expression, we construct spatiotemporal domain representation for texture features and time series representation (i.e. time series of frame-level features) for geometric features. Multiple facial features are combined through both feature fusion and decision fusion schemes to evaluate their effectiveness in infants\u27 pain assessment. Experiments are conducted on the video acquired from NICU infants, and the best accuracy of the proposed pain assessment approaches is 95.6%. Moreover, we find that although decision fusion does not perform better than that of feature fusion, the False Negative Rate of decision fusion (6.2%) is much lower than that of feature fusion (25%)