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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Inter-observer agreement in the identification of pain faces in full-term and late preterm newborns: cross-sectional study

Full text
Author(s):
Tatiany Marcondes Heiderich [1] ; Marina Carvalho de Moraes Barros [2] ; Ruth Guinsburg [3]
Total Authors: 3
Affiliation:
[1] Universidade Federal de São Paulo. Departamento de Pediatria - Brasil
[2] Universidade Federal de São Paulo. Departamento de Pediatria - Brasil
[3] Universidade Federal de São Paulo. Departamento de Pediatria - Brasil
Total Affiliations: 3
Document type: Journal article
Source: BrJP; v. 3, n. 4, p. 348-353, 2020-10-02.
Abstract

ABSTRACT BACKGROUND AND OBJECTIVES: Difficulty in neonatal assessment is a challenge for the development of pain prevention and treatment strategies. The objective of this study was to analyze the agreement among health professionals in the identification of facial pain movements in images of neonates submitted or not to a painful procedure and to evaluate the discriminatory capacity of these facial movements regarding the presence of pain. METHODS: Cross-sectional study. Six health professionals trained in neonatal pain assessment evaluated 30 images of newborns undergoing a painful procedure and 30 images of the same newborns at rest, without pain. Each professional evaluated five facial movements that are part of the Neonatal Facial Coding System. Sensitivity, specificity, and positive and negative predictive values were determined. Agreement among professionals was assessed using the kappa coefficient. RESULTS: The six observers correctly assessed 94±9% of the images obtained at rest as absence of pain and 88±28% of the images obtained during the painful procedure as presence of pain. Protruding forehead, narrowed eyelid cleft, deepened nasolabial furrow, and open mouth showed high sensitivity, specificity, and positive and negative predictive values in the diagnosis of pain, with values between 78-90%. The inter-observer agreement for all 60 images showed a kappa coefficient of 0.60 (95%CI 0.55-0.66). CONCLUSION: The evaluation of the forehead, eyelid, nasolabial furrow and mouth of newborns showed high sensitivity and specificity to discriminate the presence and absence of pain in static images. The agreement between the evaluators in identifying facial movements related to the expression of pain in newborns was moderate. (AU)

FAPESP's process: 12/50157-0 - Software development to identify facial expression of pain in newborn infants
Grantee:Ruth Guinsburg
Support Opportunities: Regular Research Grants