Neonatal procedural pain can be assessed by computer software that has good sensitivity and specificity to detect facial movements

Aim The difficulty in assessing pain during the neonatal period is one of the main obstacles for appropriate analgesia in intensive care units. The aim of this study was to develop and validate computer software to monitor neonatal facial movements of pain in real time. Methods The software was developed in the Delphi integrated development environment and provides real-time image analysis during monitoring, based on image recognition of pain-related facial actions. To validate the software performance, facial images were obtained during the monitoring of 30 neonates who were subjected to painful procedures related to daily care management. Of the 5644 images identified and analysed by the software, 360 images – 12 per infant – were randomly selected and assessed by six healthcare professionals with experience of recognising neonatal pain. Results The agreement between the examiners and the software assessment was excellent (κ = 0.975). The software exhibited 85% sensitivity and 100% specificity in detecting neutral facial expressions in the resting state and 100% sensitivity and specificity in detecting pain during painful procedures. Conclusion It is possible to assess neonatal procedural pain using computer software that has good sensitivity and specificity to detect facial movements.