Australian startup PainChek app measures pain and could help people with dementia

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To give voice to those who cannot report their suffering, such as people with dementia, PainChek, an Australian startup, has developed an app that uses facial analysis and artificial intelligence (AI) to assess and score pain levels.

A caregiver records a short video of the subject’s face using a smartphone and answers questions about their behavior, movements and speech. The app’s AI recognizes facial muscle movements associated with pain and combines them with caregiver observations to calculate an overall pain score.

According to the company, PainChek can detect pain with over 90% accuracy and over 180,000 pain assessments have been performed worldwide on more than 66,000 people. The app was designed for use by elderly people in need of care.

Generally, the assessment of pain in patients with dementia and severe communication disorders involves caregivers and healthcare professionals observing their facial expressions and behavior, and interpreting the results on a standardized scale. , such as the Abbey Pain Scale.

A team of Scientists at Curtin University School of Pharmacy in Western Australia started developing PainChek in 2012. They wanted to find a better alternative to subjective reviews on paper.

“It’s very difficult for humans to decode the emotions of a person’s face,” says Peter Shergill, Director of Business Development at PainChek. “Thus, the tool applies artificial intelligence and algorithms to decode the face based on decades of research.”

PainChek says its app can score pain with over 90% accuracy.
A 2017 validation study by the inventors of PainChek, published in the Journal of Alzheimer’s Disease, found that the app provided reliable evidence for the presence of pain. The technology is classified as a medical device in Europe, Australia and Canada and is offered to nursing homes as a monthly subscription for around $ 4 per resident.
The World Health Organization estimates that approximately 50 million people worldwide have dementia, and there are nearly 10 million new cases each year. A 2012 study estimated that up to 80% of people living in nursing homes with dementia experience pain on a regular basis.
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“Globally, the assessment of pain in people with dementia is not robust,” says Shergill. “When pain is not detected or treated in people with dementia, it can manifest as behaviors that are difficult to control, which people then try to control with antipsychotic drugs, which comes with additional risks.

In 2019, the Australian government allocated up to A $ 5 million ($ 3.8 million) for nursing homes across the country to adopt PainChek in a two-year trial. “It aims to improve the diagnosis and management of pain, quality of life and health outcomes for people living in institutions,” says Richard Colbeck, Federal Minister for Senior Australians and Elderly Care Services .

Interpret feelings

PainChek says its technology is currently in use in more than 722 nursing homes around the world. Last August it was launched in the UK, where it has been used by around 1,000 patients so far.

To use PainChek, caregivers record a short video of the subject's face and answer questions about their behavior.

Paul Rowley has a 24 bed residence in the UK and has been using PainChek for almost a year. He says 20 of his residents have been diagnosed with dementia.

“[People with dementia] have difficulty communicating and cannot necessarily articulate what they are feeling, often forcing the caregiver to interpret their feelings, ”Rowley explains. He says the app helps caregivers quickly determine if someone is in pain.

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For Rowley, PainChek is also an important tool for showing freedom from pain. He gives an example where he and his staff were able to use the app to prevent a woman from being unnecessarily medicated.

“We have a woman who is very advanced in her dementia and was showing signs that most people would interpret as physical pain,” he says. “But we knew the lady very well and we were convinced that in fact what she was manifesting was not pain but frustration and anxiety, and we used PainChek to demonstrate it.”

There are a growing number of technologies that aim to help all kinds of people communicate their pain. In the United States, MoxyTech has developed an application called GeoPain that allows users to draw exactly where they are feeling pain on a 3D image of the body. AlgometRx is a hand-held device that scans a patient’s pupils to measure pain.

PainChek is also looking to develop products targeting other groups. He conducted research at a pediatric hospital in Melbourne to help develop an app to identify pain in children under three.

“We’re looking at learning disabilities, delirium and end of life, and other additions,” says Shergill. “We have a unique solution that is transferable across ethnicities and backgrounds … users can see the impact they are having.”

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