Research
Multimodal Assessment of Neonatal Pain Using Computer Vision

Abstract
Infants receiving care in the Neonatal Intensive Care Unit (NICU) experience several painful procedures during their hospitalization. Assessing neonatal pain is difficult because the current standard for assessment is subjective, inconsistent, and discontinuous. The intermittent and inconsistent assessment can induce poor treatment and, therefore, cause serious longterm outcomes. The main aim of this project is to develop a robust and comprehensive automatic system that generates a standardized pain assessment comparable to those obtained by conventional nurse-derived pain scores. The continuous monitoring of pain, using affordable, non-invasive, and easily integrable devices, provides immediate pain detection and intervention, and therefore, contribute to improved long term outcomes; i.e., reduce the outcomes of under- and over-treatment. It can also decrease caregivers’ bias and assessment burden. While further research is needed, the preliminary results of our research showed that the automatic assessment of neonatal pain is a viable and more efficient alternative to the manual assessment.
Team
Engineering
- Dr. Yu Sun, Professor, Bellini College of AI, Cybersecurity and Computing, USF
- Dr. Dmitry Goldgof, Professor, Bellini College of AI, Cybersecurity and Computing, USF
- Jacqueline Hausmann, PhD Student, Bellini College of AI, Cybersecurity and Computing, USF
- Md Imran Hossain, PhD Student, Bellini College of AI, Cybersecurity and Computing, USF
- Anthony McCofie, PhD Student, Bellini College of AI, Cybersecurity and Computing, USF
Medical Team
- Dr. Thao Ho D.O., Pediatrics, USF Health, USF
- Marcia Kneusel RN, MPH, Pediatrics/Neonatology, USF
- Courtney Casey RN, Clinical Research Nurse, College of Medicine Pediatrics, USF Health, USF
- Dr. Stephanie Prescott PhD, MSN, NNP-BC, Director of Neonatal Research, Invoa Health Services
- Dr. Kanwaljeet S. Anand MBBS, D.Phil, Pediatrics and Anesthesiology, Stanford University
- Dr. Melissa Scala M.D., Pediatrics/Neonatology, Stanford University
- Dr. Yangxin Huang Biostatistics, College of Public Health, USF
Collaborators
- Dr. Peter Mouton, Director and Chief Scientific Officer, SRC Biosciences
- Dr. Mark Last, Professor and Director of Data Science Research Center, Ben-Gurion University of the Negev, Israel
Previous Team Members
- Dr. Denise Maguire, Associate Professor, College of Nursing, USF Health, USF
- Dr. Md Sirajus Salekin, Applied Scientist, Amazon
- Dr. Ghada Zamzmi, Research Fellow, NLM, NIH
- Jiayi Wang, PhD Student, Computer Science and Engineering, USF
- Dr. Terri Ashmeade, Professor, College of Medicine Pediatrics, USF Health, USF
- Dr. Rangachar Kasturi, Professor, CSE, USF
- Chih-Yun Pai, Master's Student, CSE, USF
Patents
- US-11631280-B2, "System and Method for Multimodal Spatiotemporal Pain Assessment", April 2023.
- US-20230309915-A1, "System and Method for Attentional Multimodal Pain Estimation", October 2023.
- US-11202604-B2, "Comprehensive and Context-sensitive Neonatal Pain Assessment System and Methods Using Multiple Modalities", December 2021.
- US-20210052215-A1, "System and Method for Multimodal Spatiotemporal Pain Assessment", Feburary 2021.
- US-20210030354-A1, "Neonatal Pain Identification From Neonatal Facial Expressions", Feburary 2021.
- US-10827973-B1, "Machine-based Infants Pain Assessment Tool", November 2020.
- US-20190320974-A1, "Comprehensive and Context-sensitive Neonatal Pain Assessment System and Methods Using Multiple Modalities", October 2020.
Published Papers
- Few-shot prompting with vision language model for pain classification in infant cry
sounds
A. McCofie, A. Kandiyana, Peter R Mouton, Yu Sun, and Dmitry Goldgof
International Symposium on Computer-Based Medical Systems (CBMS), 2025 - Automated Deep Learning Approach for Post-Operative
Neonatal Pain Detection and Prediction
through Physiological SignalsJacqueline Hausmann, Jiayi Wang, Marcia Kneusel, Stephanie Prescott, Peter R Mouton,
Yu Sun, and Dmitry Goldgof
International Symposium on Computer-Based Medical Systems (CBMS), 2025 - Explainable Neonatal Pain Assessment via Influence Function Modification
Md Imran Hossain, Ghada Zamzmi, Peter R Mouton, Yu Sun, and Dmitry Goldgof
IEEE Engineering in Medicine and Biology Society (EMBC24), 2024 - Accurate Neonatal Face Detection for Improved Pain Classification in the Challenging
NICU Setting
Jacqueline Hausmann, Md Sirajus Salekin, Ghada Zamzmi, Peter R Mouton, Stephanie M.Prescott, Yu Sun,and Dmitry Goldgof
IEEE Access, 2024 - Explainable AI for Medical Data: Current Methods, Limitations, and Future Directions
Md Imran Hossain, Ghada Zamzmi, Peter R Mouton, Md Sirajus Salekin, Yu Sun, and Dmitry Goldgof
ACM Computing Surveys, 2023 - Neonatal pain assessment: Do we have the right tools?
Amelia Llerena, Krystal Tran, Danyal Choudhary, Jacqueline Hausmann, Dmitry Goldgof, Yu Sun, and Stephanie M.Prescott
Frontier in Pediatrics, 2023 - Enhancing Neonatal Pain Assessment Transparency via Explanatory Training Examples
Identification
Md Imran Hossain, Ghada Zamzmi, Peter R Mouton, Yu Sun, and Dmitry Goldgof
2023 IEEE 36th International Symposium on Computer-Based Medical Systems (CBMS) - Attentional Generative Multimodal Network for Neonatal Postoperative Pain Estimation
Md Sirajus Salekin, Ghada Zamzmi, Dmitry Goldgof, Peter R. Mouton, Kanwaljeet J. S. Anand, Terri Ashmeade, Stephanie Prescott, Yangxin Huang, and Yu Sun
Medical Image Computing and Computer Assisted Intervention (MICCAI), 2022 - Robust Neonatal Face Detection in Real-world Clinical Settings
Jacqueline Hausmann, Md Sirajus Salekin, Ghada Zamzmi, Dmitry Goldgof, and Yu Sun
IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR) workshops, 2021 - Pattern Recognition in Vital Signs Using Spectrograms
Sidharth Srivatsav Sribhashyam, Md Sirajus Salekin, Dmitry Goldgof, Ghada Zamzmi, Mark Last, and Yu Sun
IEEE International Conference on Systems, Man, and Cybernetics (SMC), 2021 - Future Roles of Artificial Intelligence in Early Pain Management of Newborns
Md Sirajus Salekin, Peter R Mouton, Ghada Zamzmi, Raj Patel, Dmitry Goldgof, Marcia Kneusel, Sammie L Elkins, Eileen Murray, Mary E Coughlin, Denise Maguire, Thao Ho, and Yu Sun
Paediatric and Neonatal Pain, 2021 - Multimodal Neonatal Procedural and Postoperative Pain Dataset
Md Sirajus Salekin, Ghada Zamzmi, Jacqueline Hausmann, Dmitry Goldgof, Rangachar Kasturi, Marcia Kneusel, Terri Ashmeade, Thao Ho, Yu Sun
Data in Brief, 2021 - Multimodal Spatio-Temporal Deep Learning Approach for Neonatal Postoperative Pain
Assessment
Md Sirajus Salekin, Ghada Zamzmi, Dmitry Goldgof, Rangachar Kasturi, Thao Ho, Yu Sun
Computers in Biology and Medicine, 2021 - First Investigation Into the Use of Deep Learning for Continuous Assessment of Neonatal
Postoperative Pain
Md Sirajus Salekin, Ghada Zamzmi, Dmitry Goldgof, Rangachar Kasturi, Thao Ho, Yu Sun
IEEE International Conference on Automatic Face and Gesture Recognition (FG), 2020 - Harnessing the Power of Deep Learning Methods in Healthcare: Neonatal Pain Assessment
from Crying Sound
Md Sirajus Salekin, Ghada Zamzmi, Rahul Paul, Dmitry Goldgof, Rangachar Kasturi, Thao Ho, Yu Sun
IEEE Healthcare Innovations and Point of Care Technologies Conference (HI-POCT), 2019 - Multi-Channel Neural Network for Assessing Neonatal Pain from Videos
Md Sirajus Salekin, Ghada Zamzmi, Dmitry Goldgof, Rangachar Kasturi, Thao Ho, Yu Sun
IEEE International Conference on Systems, Man, and Cybernetics (SMC), 2019 - Convolutional Neural Network for Neonatal Pain Assessment
Ghada Zamzmi, Rahul Paul, Md Sirajus Salekin, Dmitry Goldgof, Rangachar Kasturi, Thao Ho, Yu Sun
IEEE Transactions on Biometrics, Behavior, and Identity Science, 2019 - Pain Assessment From Facial Expression: Neonatal Convolutional Neural Network (N-CNN)
Ghada Zamzmi, Rahul Paul, Dmitry Goldgof, Rangachar Kasturi, Terri Ashmeade, Yu Sun
International Joint Conference on Neural Networks (IJCNN), 2019 - A Comprehensive and Context-Sensitive Neonatal Pain Assessment Using Computer Vision
Ghada Zamzmi, Chih-Yun Pai, Dmitry Goldgof, Rangachar Kasturi, Terri Ashmeade, Yu Sun
IEEE Transactions on Affective Computing, 2019 - Toward Ubiquitous Assessment of Neonates' Health Condition
Ghada Zamzmi, Dmitry Goldgof, Rangachar Kasturi, Yu Sun
UbiComp, 2018 - Automatic Infants’ Pain Assessment by Dynamic Facial Representation: Effects of Profile
View, Gestational Age, Gender, and Race
Ruicong Zhi, Ghada Zamzmi, Dmitry Goldgof, Terri Ashmeade, Yu Sun
Journal of Clinical Medicine, 2018 - Infants' Pain Recognition Based on Facial Expression: Dynamic Hybrid Descriptions
Ruicong Zhi, Ghada Zamzmi, Dmitry Goldgof, Terri Ashmeade, Tingting Li, Yu Sun
IEICE Transactions on Information and Systems, 2018 - A Review of Automated Pain Assessment in Infants: Features, Classification Tasks,
and Databases
Ghada Zamzmi, Rangachar Kasturi, Dmitry Goldgof, Ruicong Zhi, Terri Ashmeade, Yu Sun
IEEE Reviews in Biomedical Engineering, 2018 - Automated Pain Assessment in Neonates
Ghada Zamzmi, Chih-Yun Pai, Dmitry Goldgof, Rangachar Kasturi, Yu Sun, Terri Ashmeade
Scandinavian Conference on Image Analysis (SCIA), 2017 - An Approach for Automated Multimodal Analysis of Infants' Pain
Ghada Zamzmi, Chih-Yun Pai, Dmitry Goldgof, Rangachar Kasturi, Terri Ashmeade, Yu Sun
International Conference on Pattern Recognition (ICPR), 2016 - Pain Assessment in Infants: Towards Spotting Pain Expression Based on Infants' Facial
Strain
Ghada Zamzami, Gabriel Ruiz, Dmitry Goldgof, Rangachar Kasturi, Yu Sun, Terri Ashmeade
IEEE International Conference and Workshops on Automatic Face and Gesture Recognition (FG), 2015
Media Coverage
- Jun 15, 2021 - USF Research and Innovation Newsroom 2021
- Jun 14, 2017 - USF Magazine Summer 2017
- Mar 24, 2017 - USF Health
- Feb 22, 2017 - FOX 13 News
Talk / Presentation
- Aug 06, 2019 - Dr. Dmitry Goldgof, A joint seminar of the Data Science Research Center and the Department of Biomedical Engineering at Ben-Gurion University of Negev, Israel on "Healthcare in the Age of AI and Deep Learning: Automatic Assessment of Neonatal Pain"
- Jun 18, 2019 - Dr. Dmitry Goldgof, Weekly Idea/Research Collabaration Meeting at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA, on "Automatic Neonatal Pain Detection"
- Mar 26, 2019 - Dr. Dmitry Goldgof, High Profile Talk at University of South Florida, Tampa, FL, USA, on "Healthcare in the Age of AI and Deep Learning: Automatic Assessment of Neonatal Pain"