Pain is typically assessed by patient self-report. Self-reported pain, however, is difficult to interpret and may be impaired or in some circumstances (i.e., young children and the severely ill) not even possible. To circumvent these problems behavioral scientists have identified reliable and valid facial indicators of pain. Hitherto, these methods have required manual measurement by highly skilled human observers. In this paper we explore an approach for automatically recognizing acute pain without the need for human observers. Specifically, our study was restricted to automatically detecting pain in adult patients with rotator cuff injuries. The system employed video input of the patients as they moved their affected and unaffected shoulder. Two types of ground truth were considered. Sequence-level ground truth consisted of Likert-type ratings by skilled observers. Frame-level ground truth was calculated from presence/absence and intensity of facial actions previously associated with pain. Active appearance models (AAM) were used to decouple shape and appearance in the digitized face images. Support vector machines (SVM) were compared for several representations from the AAM and of ground truth of varying granularity. We explored two questions pertinent to the construction, design and development of automatic pain detection systems. First, at what level (i.e., sequence- or frame-level) should datasets be labeled in order to obtain satisfactory automatic pain detection performance? Second, how important is it, at both levels of labeling, that we non-rigidly register the face?

Temporal segmentation of facial gestures in spontaneous facial behavior recorded in real-world settings is an important, unsolved, and relatively unexplored problem in facial image analysis. Several issues contribute to the challenge of this task. These include non-frontal pose, moderate to large out-of-plane head motion, large variability in the temporal scale of facial gestures, and the exponential nature of possible facial action combinations. To address these challenges, we propose a two-step approach to temporally segment facial behavior. The first step uses spectral graph techniques to cluster shape and appearance features invariant to some geometric transformations. The second step groups the clusters into temporally coherent facial gestures. We evaluated this method in facial behavior recorded during face-to- face interactions. The video data were originally collected to answer substantive questions in psychology without concern for algorithm development. The method achieved moderate convergent validity with manual FACS (Facial Action Coding System) annotation. Further, when used to preprocess video for manual FACS annotation, the method significantly improves productivity, thus addressing the need for ground-truth data for facial image analysis. Moreover, we were also able to detect unusual facial behavior.

Pain is typically assessed by patient self-report. Self-reported pain, however, is difficult to interpret and may be impaired or not even possible, as in young children or the severely ill. Behavioral scientists have identified reliable and valid facial indicators of pain. Until now they required manual measurement by highly skilled observers. We developed an approach that automatically recognizes acute pain. Adult patients with rotator cuff injury were video-recorded while a physiotherapist manipulated their affected and unaffected shoulder. Skilled observers rated pain expression from the video on a 5-point Likert-type scale. From these ratings, sequences were categorized as no-pain (rating of 0), pain (rating of 3, 4, or 5), and indeterminate (rating of 1 or 2). We explored machine learning approaches for pain-no pain classification. Active Appearance Models (AAM) were used to decouple shape and appearance parameters from the digitized face images. Support vector machines (SVM) were used with several representations from the AAM. Using a leave-one-out procedure, we achieved an equal error rate of 19% (hit rate = 81%) using canonical appearance and shape features. These findings suggest the feasibility of automatic pain detection from video.

Past research on automatic facial expression analysis has focused mostly on the recognition of prototypic expressions of discrete emotions rather than on the analysis of dynamic changes over time, although the importance of temporal dynamics of facial expressions for interpretation of the observed facial behavior has been acknowledged for over 20 years. For instance, it has been shown that the temporal dynamics of spontaneous and volitional smiles are fundamentally different from each other. In this work, we argue that the same holds for the temporal dynamics of brow actions and show that velocity, duration, and order of occurrence of brow actions are highly relevant parameters for distinguishing posed from spontaneous brow actions. The proposed system for discrimination between volitional and spontaneous brow actions is based on automatic detection of Action Units (AUs) and their temporal segments (onset, apex, offset) produced by movements of the eyebrows. For each temporal segment of an activated AU, we compute a number of mid-level feature parameters including the maximal intensity, duration, and order of occurrence. We use Gentle Boost to select the most important of these parameters. The selected parameters are used further to train Relevance Vector Machines to determine per temporal segment of an activated AU whether the action was displayed spontaneously or volitionally. Finally, a probabilistic decision function determines the class (spontaneous or posed) for the entire brow action. When tested on 189 samples taken from three different sets of spontaneous and volitional facial data, we attain a 90.7% correct recognition rate.