How well do we interpret pain and how well do doctors interpret pain in the faces of their patients? A new study suggests not as well as a computer, according to a study in Current Biology. The findings could have ramifications for how physicians work with patients to manage pain, especially in children.
The study, written up in The New York Times, involved showing humans and a computer videos of people expressing real pain or pretending as much and each group had to spot the difference. Those expressing real pain had submerged their arms in cold water for one minute. The computer was able to do a better job by identifying muscle movement patterns in their faces.
It’s not that people lack empathy, but they look for the wrong cues, according to Marian S. Bartlett, a professor with the Institute for Neural Computation at San Diego who was the lead author of the study.
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Even with an hour of training in which participants would see faces expressing real or faked pain and immediately learn the correct answer, it didn’t make a significant difference in their interpretation of the cues.
So what are some of these subtle cues the computer could pick up? First of all they looked at the speed, smoothness and duration of the muscle contractions. People faking it have no problem maintaining a pained expression — they tended to keep their mouths open for longer. For people in real pain there was more variety in how long they maintained an open mouth.
But even computers are not perfect and the one in the study scored 85 percent.
Jeffrey Cohn, a University of Pittsburgh professor of psychology and Bartlett are developing a way to use facial expressions in healthcare with an eye to pediatrics. Bartlett is collaborating with a San Diego hospital to assess pain intensity in children.
The reactions to The New York Times story on the experiment were just as interesting as the study. It drew concern that it would be used as some sort of high-tech way to assess drug-seeking behavior. Others were worried it indicated a lack of trust in and empathy for patients. And yet, it seems like the technology is really about providing an extra layer of communication support for children too young to express themselves clearly or maybe even in cases where there is a communication problem.
[Photo credit: Doodles from BigStock Photo]
