Related Experiment Video
Updated: Jan 6, 2026
Electrophysiological Measurements and Analysis of Nociception in Human Infants
Published on: December 20, 2011
Development and Verification of a New Method for Evaluating Facial Expressions Based on the Premature Infant Pain
Hisako Saiki1, Rie Fukuhara2, Minoru Matsushima3
1Department of Neonatology, Hiroshima Prefectural Hospital, Hiroshima, Japan, hisako.k20@gmail.com.
Insights
A new simplified method for assessing neonatal pain, based on the Premature Infant Pain Profile-Revised (PIPP-R), effectively evaluates facial expressions. This approach shows high consistency with traditional methods for term infants.
Area of Science:
- Neonatal care
- Pain assessment tools
- Pediatric research
Background:
- Multidimensional pain evaluation tools are recommended for neonates.
- Existing tools are complex and challenging to use in Japan.
- Simplified pain assessment is needed for clinical practice.
Purpose of the Study:
- To develop and validate a simplified facial expression assessment method for neonatal pain.
- To compare the new method with the conventional Premature Infant Pain Profile-Revised (PIPP-R) scoring.
- To assess the reliability and consistency of the new method.
Main Methods:
- Developed a new method simplifying PIPP-R facial expression evaluation into four categories.
- Implemented a system for automatic vital sign recording and scoring.
- Compared the new method (real-time and video-based) with conventional PIPP-R scoring using recorded videos.
Main Results:
- The study included 63 healthy term neonates (≥37 weeks' gestation).
- High levels of agreement were found between the new method and conventional PIPP-R scoring.
- High inter-rater agreement confirmed the reliability of the new assessment method.
Conclusions:
- The novel facial expression assessment method is equivalent to conventional PIPP-R scoring in full-term neonates.
- Further validation is required in preterm infants and varied clinical environments.
- This simplified approach may improve neonatal pain management.
Introduction:
The use of reliable, validated, and multidimensional tools for pain evaluation has been recommended to manage neonatal pain. However, these tools have limited use in Japan due to their complexity, which involves numerous evaluation and observation items, making thorough observation challenging.
Methods:
We developed a new method based on the Premature Infant Pain Profile-Revised (PIPP-R), a multidimensional evaluation tool that includes physiological and behavioral indicators, to simplify the evaluation of facial expressions. Instead of assessing three facial expressions individually, we evaluate them in four categories. We also created a system that automatically records changes in vital signs and calculates scores. In this study, we determined if the facial expression score aligns with the conventional PIPP-R-based facial expression score. The scoring methods were categorized into three types: (1) a real-time new method, where facial expressions were evaluated concurrently with the puncture procedure using a new method; (2) an individual assessment method using recorded videos from the puncture sessions with facial expressions scored later using the PIPP-R; and (3) a new video-based method, in which facial expressions were evaluated using the new method while watching recorded videos.
Results:
The study included 63 healthy neonates (born at ≥37 weeks' gestation) delivered at our hospital. The degree of agreement among the methods and the inter-rater agreement showed high levels of consistency.
Conclusion:
The new facial expression assessment method based on the PIPP-R demonstrated equivalence to conventional scoring in full-term neonates. Further validation, particularly in preterm infants and diverse clinical settings, is needed.
More Related Videos
07:12Protocol for Data Collection and Analysis Applied to Automated Facial Expression Analysis Technology and Temporal Analysis for Sensory Evaluation
Published on: August 26, 2016
06:29Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
Published on: November 29, 2017
