Neonatal Pain Scales and Human Visual Perception: An Exploratory Analysis Based on Facial Expression Recognition and Eye-Tracking

Neonates feel pain and the more premature they are, the more immature are their pain modulation system. Facial expression recognition is a non-invasive method commonly used in clinical practice to identify and assess pain in neonates. In this context, this paper firstly carries out a systematic and state-of-the-art review of several clinical pain scales based on neonatal facial features. Then, we propose and implement an eye-tracking exploratory analysis of the neonate’s facial regions described in these scales to identify the most preferred ones visually for such pain assessment by 4 distinct sample groups of volunteers: 44 physicians, 40 health professionals, 29 parents of newborns and 30 lay people. Our results show differences in all sample groups, either experts or not, between the facial regions considered clinically relevant to the ones expressed implicitly by the human visual perception.