Computational analysis of the language of pain: a systematic review

Objectives: This study aims to systematically review the literature on the computational processing of the language of pain, whether generated by patients or physicians, identifying current trends and challenges. Methods: Following the PRISMA guidelines, a comprehensive literature search was conducted to select relevant studies on the computational processing of the language of pain and answer pre-defined research questions. Data extraction and synthesis were performed to categorize selected studies according to their primary purpose and outcome, patient and pain population, textual data, computational methodology, and outcome targets. Results: Physician-generated language of pain, specifically from clinical notes, was the most used data. Tasks included patient diagnosis and triaging, identification of pain mentions, treatment response prediction, biomedical entity extraction, correlation of linguistic features with clinical states, and lexico-semantic analysis of pain narratives. Only one study included previous linguistic knowledge on pain utterances in their experimental setup. Most studies targeted their outcomes for physicians, either directly as clinical tools or as indirect knowledge. The least targeted stage of clinical pain care was self-management, in which patients are most involved. The least studied dimensions of pain were affective and sociocultural. Only two studies measured how physician performance on clinical tasks improved with the inclusion of the proposed algorithm. Discussion: This study found that future research should focus on analyzing patient-generated language of pain, developing patient-centered resources for self-management and patient-empowerment, exploring affective and sociocultural aspects of pain, and measuring improvements in physician performance when aided by the proposed tools.

Chronic pain patient narratives allow for the estimation of current pain intensity

Chronic pain is a multi-dimensional experience, and pain intensity plays an important part, impacting the patients emotional balance, psychology, and behaviour. Standard self-reporting tools, such as the Visual Analogue Scale for pain, fail to capture this burden. Moreover, this type of tools is susceptible to a degree of subjectivity, dependent on the patients clear understanding of how to use it, social biases, and their ability to translate a complex experience to a scale. To overcome these and other self-reporting challenges, pain intensity estimation has been previously studied based on facial expressions, electroencephalograms, brain imaging, and autonomic features. However, to the best of our knowledge, it has never been attempted to base this estimation on the patient narratives of the personal experience of chronic pain, which is what we propose in this work. Indeed, in the clinical assessment and management of chronic pain, verbal communication is essential to convey information to physicians that would otherwise not be easily accessible through standard reporting tools, since language, sociocultural, and psychosocial variables are intertwined. We show that language features from patient narratives indeed convey information relevant for pain intensity estimation, and that our computational models can take advantage of that. Specifically, our results show that patients with mild pain focus more on the use of verbs, whilst moderate and severe pain patients focus on adverbs, and nouns and adjectives, respectively, and that these differences allow for the distinction between these three pain classes.