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There is a real need for this technology, says Martin. “It would be very welcome if you could remove some of the subjectivity,” he says. There is also evidence to suggest that allowing infants to experience pain can impair their neurological development over time, he says. “We’re talking about an immaturity in children responding to stress years later.”

Pain is a frontline defense mechanism and often the first sign that something is wrong, says Brahnam. So apart from the issue of preventing another human being from suffering, there are medical benefits to alleviating pain as soon as possible, she says. If fitted above NICU cots, a system like COPE could help medical staff automatically detect when a patient develops problems.

There is now a lot of interest in finding ways to automatically detect pain, says Rosalind Picard, director of affective computing research at Massachusetts Institute of Technology, in Cambridge. And the applications are not limited to neonates, she says.

Picard has already been approached by anaesthesiologists who are keen to find ways to monitor the pain that patients are experiencing during surgery. “There are some facial expressions that are involuntary,” she says. There are also countless examples of people regaining consciousness during surgery. Horrifically, these patients later report having felt everything the surgeon was doing to them and yet being unable to tell anyone because of the paralyzing effects of the drugs. In theory, it may be possible to detect the involuntary muscle movements of the face to determine when this is happening, Picard says.

Brahnam and her colleagues’ work will appear in a forthcoming issue of the journal Decision Support Systems. They are now working on a follow-up study involving 500 infants and using video images. Moving images should allow the researchers to investigate the dynamic characteristics of pain expressions, she says.

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