ArticlePaediatric & neonatal pain2019
Multimodal pain assessment improves discrimination between noxious and non-noxious stimuli in infants.
Article in Paediatric & neonatal pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Artificial intelligence in pediatric pain: a systematic review.BMC medical informatics and decision making · 2026Pooled it
- Electroencephalography during acute painful procedures in neonates: a scoping review.Pain reports · 2026Review
- Pain assessment using physiological responses/markers in different types of pain: a scoping review.NPJ digital medicine · 2026Article
- Application of Intelligent Neonatal Pain Assessment Tools Based on Multimodal Data Fusion: A Systematic Review.Journal of pain research · 2026Review
- Machine learning classification of EEG responses to pain-related vs non-pain-related stimulus in preterm infants.Pain reports · 2025Article
- Objective Detection of Newborn Infant Acute Procedural Pain Using EEG and Machine Learning Algorithms.Paediatric & neonatal pain · 2025Article
- Decoding of pain during heel lancing in human neonates with EEG signal and machine learning approach.Scientific reports · 2024Article
- A machine learning artefact detection method for single-channel infant event-related potential studies.Journal of neural engineering · 2024Article
- Early prediction of severe retinopathy of prematurity requiring laser treatment using physiological data.Pediatric research · 2023Article
- The fetal pain paradox.Frontiers in pain research (Lausanne, Switzerland) · 2023Review
- Article
- Premature infants display discriminable behavioral, physiological, and brain responses to noxious and nonnoxious stimuli.Cerebral cortex (New York, N.Y. : 1991) · 2022Article
- The impact of premature extrauterine exposure on infants' stimulus-evoked brain activity across multiple sensory systems.NeuroImage. Clinical · 2022Article
- Toward personalized medicine for pharmacological interventions in neonates using vital signs.Paediatric & neonatal pain · 2021Review
- Future roles of artificial intelligence in early pain management of newborns.Paediatric & neonatal pain · 2021Review
- Functional and diffusion MRI reveal the neurophysiological basis of neonates' noxious-stimulus evoked brain activity.Nature communications · 2021Article
- Quantifying noxious-evoked baseline sensitivity in neonates to optimise analgesic trials.eLife · 2021Observational
- Inferring pain experience in infants using quantitative whole-brain functional MRI signatures: a cross-sectional, observational study.The Lancet. Digital health · 2020Observational
- Multimodal pain assessment improves discrimination between noxious and non-noxious stimuli in infants.Paediatric & neonatal pain · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Infants in neonatal intensive care units frequently experience clinically necessary painful procedures, which elicit a range of behavioral, physiological, and neurophysiological responses. However, the measurement of pain in this population is a challenge and no gold standard exists. The aim of this study was to investigate how noxious-evoked changes in facial expression, reflex withdrawal, brain activity, heart rate, and oxygen saturation are related and to examine their accuracy in discriminating between noxious and non-noxious stimuli. In 109 infants who received a clinically required heel lance and a control non-noxious stimulus, we investigated whether combining responses across each modality, or including multiple measures from within each modality improves our ability to discriminate the noxious and non-noxious stimuli. A random forest algorithm was used to build data-driven models to discriminate between the noxious and non-noxious stimuli in a training set which were then validated in a test set of independent infants. Measures within each modality were highly correlated, while different modalities showed less association. The model combining information across all modalities had good discriminative ability (accuracy of 0.81 in identifying noxious and non-noxious stimuli), which was higher than the discriminative power of the models built from individual modalities. This demonstrates the importance of including multiple modalities in the assessment of infant pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.