WO2019136246A1

WO2019136246A1 - Multidimensional tracking of pain

Info

Publication number: WO2019136246A1
Application number: PCT/US2019/012345
Authority: WO
Inventors: Pavel GOLDSTEIN; Tor D. WAGER; Mehmet KAZGAN; Burak CETIN
Original assignee: Cliexa Inc; University of Colorado System; University of Colorado Colorado Springs
Current assignee: Cliexa Inc; University of Colorado System; University of Colorado Colorado Springs
Priority date: 2018-01-05
Filing date: 2019-01-04
Publication date: 2019-07-11
Anticipated expiration: 2020-07-05

Abstract

A mobile application framework is provided for evaluating pain and emotional state of a patient remotely. The mobile application uses hardware commonly existing in smartphones and tablet devices such as microphones and cameras to capture speech and gestures which form indicia for computation analysis and quantification of pain levels and emotional states of the user. The user may be prompted to read a preset dialog standardized from a statistically meaningful population for pain and emotion analysis. Such physical manifestations of pain indicia are then stored, transmitted and reported to health care providers to adjust patient care or initiate intervention. The user may also self-report pain and emotional state through the mobile application which therefore provides both subjective and objective data to health care providers. Additionally, self-reporting and computationally derived values may adjust a machine learning algorithm to enhance accuracy as data accumulates.

Description

MULTIDIMENSIONAL TRACKING OF PAIN

CROSS-REFERENCE TO RELATED APPLICATIONS

This nonprovisional application claims priority to U.S. Provisional Patent Application No. 62/614,024, entitled“Multidimensional Tracking of Pain,” filed January 5, 2018 by the same inventors, the entirety of each is incorporated herein by this reference.

FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

This invention was made with government support under grant numbers DA035484 and MH076136 awarded by the National Institutes of Health. The government has certain rights in the invention.

TECHNICAL FIELD

This invention relates to pain management. More specifically, it relates to translating speech patterns and video data into pain level quantifications and emotional states through computer-based processing.

BACKGROUND

In the past, pain was considered outside the realm of medicine because of its subjective nature, and often ignored and left untreated. This outlook has changed in recent times, and now the assessment and treatment of pain has become an integral part of medical practice.

Pain is a complex phenomenon that is affected by multiple factors and expressed in multiple ways. Pain influences, and is influenced by, emotional health, stress, and fatigue. Like pain, emotions are not abstract feelings - they are felt in the body and influenced by bodily processes.

While research has shown that patient self-report instruments are an economical and reliable means of assessing a person's pain condition, the means for doing this has generally been limited to handwritten diaries. With or without handwritten diaries, diagnosing and treating patients with pain disorders involves sorting through and evaluating large amounts of information. When a patient experiences different degree of pain over a given period it can be time consuming for the health care professional to record all the information. In addition to consuming a large amount of time, it can be difficult forthe health care professional to effectively analyze all the information collected, or to collect wholistic information regarding emotional state, state of mind, and external stressors.

As the amount of information provided to a health care professional increases, so does the probability that the health care professional will overlook relevant symptoms or fail to recognize a correlation between a symptom and other information provided to the health care professional. As a result, the health care professional may order the patient to undergo unnecessary tests. For the patient, it is difficult to recall the exact nature and location of pain, particularly if its occurrence happens over a long period of time. Specific periods or moments may be recalled, but details of its occurrence (e.g. time, date, place), and variables (e.g. symptoms, medications) associated with it, before, during and after the occurrence of pain may go unreported.

Currently, there is no electronic platform that allows patients to record and track interactions between pain, emotion, and bodily experiences, and no way of delivering information about these experiences to clinicians who could use it to understand and improve patient health. Methods such as that used in U.S. Patent No. 6,856,315 are not wholistic and use only location and quality of pain while not addressing the multidimensional aspect of acute and chronic pain. There exists a need for a system to address pain and information gathering in a wholistic manner. The system should allow for patients and physicians to see the relationships between medication use, pain, and emotion over time, to improve identification of the causes and triggers of negative outcomes and optimize treatment for individual patients.

While certain aspects of conventional technologies have been discussed to facilitate disclosure of the instant application, Applicants in no way disclaim these technical aspects, and it is contemplated that the instant application may encompass one or more of the conventional technical aspects discussed herein.

The present disclosure may address one or more of the problems and deficiencies in the art discussed above. However, it is contemplated that this disclosure may prove useful in addressing other problems and deficiencies in many technical areas. Therefore, the present application should not necessarily be construed as limited to addressing any of the problems or deficiencies discussed herein.

In this specification, where a document, act or item of knowledge is referred to or discussed, this reference or discussion is not an admission that the document, act or item of knowledge or any combination thereof was at the priority date, publicly available, known to the public, part of common general knowledge, or otherwise constitutes prior art under the applicable statutory provisions; or is known to be relevant to an attempt to solve any problem described in this specification.

SUMMARY

The present invention is a mobile application for tracking interactions between pain, pain medication, fatigue, stress, and multiple emotions over time, and allowing patients to report these experiences in an effortless and engaging way. The application also captures patterns of speech and facial expressions, which deliver a readout of patients implicit (or unconscious) emotional state. The application is used by patients for self-monitoring and self-insight, and delivers interactive graphics to clinicians and care providers, providing an easy-to-digest picture of emotional health and pain over time. Embodiments disclosed herein include methods of quantitatively and qualitatively evaluating pain, as well as related steps. For example, in accordance with one embodiment, a method of evaluating pain including capturing multidimensional pain data including capturing speech and video data of a patient on a mobile computing device operated by the patient, capturing self-reported pain character and medication adherence by the patient, capturing emotional and psychological information from the patient, analyzing the speech and video data for indicia of bodily pain, analyzing the video data for face expression for indicia of bodily pain, quantifying the indicia of bodily pain into relative values, and reporting the relative values to a health care provider.

In additional embodiments, a method of evaluating pain including wherein capturing speech and video data, as well as self-reported pain and medication adherence is collected as a first set of data by the patient during a first time period; and wherein capturing speech and video data, as well as self-reported pain and medication adherence is collected as a second set of data by the patient during a second time period; and wherein the first and second sets of data are received at a first computer connected to a computer network and transmitted to a pain tracking computer coupled to the computer network.

A method of evaluating pain wherein the first and second sets of data transmitted to the pain tracking computer is at a different location from the first computer.

A method of evaluating pain wherein the first and second sets of data is accessible by a health care professional at a location difference from the location of the patient and the location of the pain tracking computer.

A method of evaluating pain wherein the relative values include at least two variables and wherein at least two variables include pain characteristics, emotional and psychological information, speech and video data, medications, and other symptoms. A method of evaluating pain wherein the emotional and psychological information includes state of mind and mood of the patient. A method of evaluating pain wherein the pain characteristics include at least one of pressure, throbbing, aching, sharp, and pulling.

A method of evaluating pain wherein the emotional and psychological information include at least one of happy, unhappy, angry, depressed, anxious, fear, fear of pain, stressed, relaxed, tired, sad, relieved, apathy, low energy, no interest in doing things, and difficulty concentrating.

A method of evaluating pain wherein the patient also captures other symptoms such as fatigue, other illnesses, loss of appetite, sleep data, urination, menstrual pain and discomfort, breast tenderness, or other symptoms associated with other disease states such as diabetes.

A method of evaluating pain wherein the medication adherence includes the type of medication and the disease state for which it was prescribed. A method of evaluating pain wherein the speech data provides data on the quality of the patient’s speech which can include pressured speech, muted speech, halting speech patterns, and other indicia of pain found in speech. A method of evaluating pain wherein the video data provides data on the patient’s facial expressions and movements which provides information and other indicia of pain manifested in the patient’s face.

A method of evaluating pain further including the step of obtaining at least one alarm condition and transmitting an alert when at least one of the alarm conditions have been met.

A method of evaluating pain wherein at least one alarm condition includes patient self- reported mood and wherein the transmitting an alert includes at least sending an e-mail message which prompts the patient or health care provider to act.

In an alternative embodiment, a computer programmed to perform the methods described above to evaluate multidimensional pain values.

In an alternative embodiment, a computer readable medium containing computer- executable instruction for performing the methods described above to evaluate multidimensional pain values.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims particularly pointing out and distinctly claiming what are regarded as embodiments of the invention, the advantages of embodiments of the disclosure may be more readily ascertained from the description of certain examples of embodiments of the disclosure when read in conjunction with the accompanying drawings, in which:

FIG. 1 shows chart data representative of healthy and chronic pain processes.

FIG. 2 show thermal imaging of anthropomorphic shapes representative of differing emotional states.

FIG. 3 is a mobile graphic user interface according to an embodiment of the invention.

FIG. 4 is a diagrammatic view of information collected and transmitted to a health care provider.

FIG. 5 depicts a system for tracking and displaying pain according to an embodiment of the invention.

FIG. 6 depicts a method for tracking and displaying pain according to an embodiment of the invention.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

In the following detailed description, reference is made to the accompanying drawings, which form a part thereof, and within which are shown by way of illustration specific embodiments by which the invention may be practiced. It is to be understood that other embodiments may be used, and structural changes may be made without departing from the scope of the present application. These embodiments are described in enough detail to enable those of ordinary skill in the art to practice the present disclosure, and it is to be understood that other embodiments may be used, and that structural, logical, and electrical changes may be made within the scope of the disclosure.

The embodiments as generally described and illustrated in the figures herein could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of various embodiments, as represented in the figures, is not intended to limit the scope of the disclosure but is merely representative of various embodiments. The figures presented are not meant to be illustrative of actual views of any portion of the actual structure or method but are merely idealized representations employed to more clearly and fully depict the present invention defined by the claims below.

Any reference to an element herein using a designation such as“first,”“second,” and so forth does not limit the quantity or order of those elements, unless such limitation is explicitly stated. Rather, these designations may be used herein as a convenient method of distinguishing between two or more elements or instances of an element.

Any reference to a computer is contemplated to include tablets, mobile phones, computers, laptops, or any other device capable of computing.

Any headings used herein should not be considered to limit the scope of embodiments of the invention as defined by the claims below and their legal equivalents. Concepts described in any specific heading are generally applicable in other sections throughout the entire specification.

As used in this specification and the appended claims, the singular forms“a”,“an”, and“the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term“or” is generally employed in its sense including “and/or.” As used herein, the term “subject,” “patient,” or “user,” are interchangeable.

The phrases“connected to” and“coupled to” refer to any form of interaction between two or more entities, including mechanical, electrical, magnetic, electromagnetic, fluid, and thermal interaction. Two components may be connected or coupled to each other even though they are not in direct contact.

All referenced publications are incorporated herein by reference in their entirety. Furthermore, where a definition or use of a term in a reference, which is incorporated by reference herein, is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.

Recent research highlighted a significant role of psychological health for pain patient well-being. Chronic pain patients show abnormal and maladaptive response to life stressors (Fig. 1) resulting in depression, anxiety and emotional disorders that may in turn amplify pain level and affect their well-being. As shown in Fig. 1 , under normal conditions, adaptive responses occur to a stressor (e.g., nociceptive pain). However, with stressors that results in ongoing process (e.g., neuropathic pain), responses become abnormal and maladaptive (e.g. onset of depression). Fig. 1 depicts the healthy adaptive process 102 and the maladaptive process of chronic pain 104. Fig. 1 also depicts the type of individual responses to chronic pain 106. The individual responses to chronic pain 106 may include: pain intensity, autonomic disturbance, sex drive, appetite, sleep disturbance, depression, anxiety, motor activity, and cognitive dysfunction.

In addition, chronic pain patients have impaired emotional awareness. For example, alexithymia, a deficit in one’s ability to identify feelings, is elevated in a range of disorders, particularly in central sensitization conditions such as lower back pain, fibromyalgia, and temporomandibular disorder. Unfortunately, this knowledge has not been implemented by healthcare providers for treating people with pain conditions. Moreover, patient evaluation of health care services is highly dependent on their emotional states. Thus, tracking emotional states of pain patients may help clinicians to understand patients’ current emotional states, identifying psychological disorders and sending alert notifications to both patients and clinicians. Such feedback may significantly improve patient life quality by providing an appropriate treatment.

There is a complex set of interactions between pain, medication use, and emotion, which varies across individual patients. If patients and physicians could see the relationships between medication use, pain, and emotion over time, it would be easier to identify the causes and triggers of negative outcomes and optimize treatment for individual patients.

Despite the immense body of research dedicated to the investigation of pain, we still lack effective pain therapies without significant side effects. Moreover, current treatment approaches concentrate mostly on treating physical pain intensity, considering a patient as a passive unit and moving away from addressing his suffering. Suffering spans physical, social, spiritual and emotional domains, and as a whole-person (wholistic) problem it is underestimated by the current medical care systems. For decades, clinicians have been urged to listen intently and to paraphrase accurately as bases for establishing the patient’s major problems and for establishing a plan of care, leaving the patients with a feeling of not been understood or heard.

Different emotions are consistently associated with separable bodily sensation maps (Fig. 2) and these bodily sensation maps changed from less to more specific, adult-like patterns as a function of age. Some physiological bases of this phenomenon are already discovered. For example, current research discovered that bidirectional brain-gut communication affects our emotions and the path could be used for treating depression and anxiety.

Thus, collecting body maps of pain patients’ emotional states and pain serves as a diagnostic tool, providing useful feedback for both patients and their clinicians. Moreover, the emotions body maps may have a therapeutic “side effect,” serving as a mindfulness intervention. In line with current research that showed effectiveness of mind-body therapy which concentrates on body sensations for treating chronic pain. Tests have been conducted that examine the brain mechanisms involved in mind-body therapy for lower back pain. A simple application for body sensation awareness may benefit pain patients.

Psychological health of pain patients

Since depression, anxiety, and pain are deeply interrelated, these disorders have been monitored to alert clinicians about their patient psychological states to prevent an aggravation, using scientifically validate and clinically accepted tools. In addition, patient data has been collected about their emotional states, and pain categorization. The collected data is used for development of predictive analytics tool for patient psychological health and pain. Fig. 2 shows bodily topography of basic (Upper) and non-basic (Lower) emotions. The body maps show regions whose activation increased (10 to 15 range of grayscale) or decreased (-10 to -15 of the grayscale) when feeling each emotion.

Pain expression in the voice, face, and body movements

In addition, our emotions and pain are detectable through face expressions, body movements, our voice features and speech content. It is possible to accurately predict pain based on voice emotional features (77% accuracy), dynamic face expressions (91 % accuracy) and using both voice and video features (98% accuracy). Gestural pain communication is enhanced when pain is more intense, representing different aspects of pain sensation expressed in voice. Moreover, sentiment analysis (speech content) shows an ability to predict different psychological concepts as depression based on social media post or speech content. This kind of analysis is also applicable for prediction of pain levels.

However, most of the existing approaches for pain/emotions classification were built using a non-realistic data collected in a laboratory environment, performing poorly if they are applied to a more-realistic clinical data. Thus, collecting audio/video recordings of pain patients, talking about their current symptoms and emotions in their natural conditions, supplies valuable multi-source information for the better understanding of their physical and emotional well-being and providing important feedback for the patients and their clinicians.

A simple and effective way to collect the needed data is through a mobile application. The present invention includes a mobile platform for tracking pain patient emotions based on following principles: simplicity, scientifically proven and clinically validated tools, real- time feedback for patients and clinicians. The app allows patients:

1) To self-report body expressions of emotional states, pain, stress and fatigue in a user-friendly and engaging way, this patient input 302, can provide timelines of pain 306 related emotional states, linked with other information, such as medication history 308, and overall quality of pain 304, back to the patient and to care providers as depicted in Fig. 3. This is also depicted in Fig. 4 as the pain and medication adherence tracking information 402 and emotional body maps 404.

2) To video themselves talking about their current physical conditions and emotional states. Based on this multi-source data a deep learning model is available for prediction pain patient emotional states and pain levels based on a) emotional characteristics of the voice; b) sentimental analysis of speech content; c) dynamic face expressions and d) body movements. As depicted in Fig. 4 this is the speech and voice analysis 408.

3) To report symptoms, medical adherence and self-reported measurements of psychological health (e.g. depression, anxiety, emotional states, pain categorization) as depicted in Fig. 4 this is the patient psychological health 406. The mobile application provides valuable feedback about patients’ physical and emotional well-being, identifying patients at risk.

Voice and speech data is analyzed using machine learning to determine the model that may take combinations of a multitude of speech features (characteristics).

Fig. 3 shows a screenshot of the pain and emotions body maps in the patient input 302. A user can locate pain and multiple emotional states, into the appropriate body parts, estimating also the experienced intensity. Fig. 3 also shows an example of feedback provided to patient and clinician. An association between pain, emotions and medication.

Fig. 4 provides a visual summary of the application and the feedback directions. Since body awareness therapy have a therapeutic effect in pain conditions, the personalized feedback for a patient, provided by the application, may serve as a treatment, improving a pain condition and general well-being. The patient 412 provides information on pain and medication adherence 402; emotional body map information 404; psychological health 406; speech and voice analysis 408; and face expression analysis 410. This information then is gathered in the cloud 414 or internet where the health care provider 416 can access it. The face expression analysis 410 in some embodiments is a picture taken by the patient of their face at the time they are entering information into the system which is then time coded.

Fig. 5 depicts a system 500 for tracking and displaying pain in accordance with an embodiment of the claimed subject matter. A user enters wholistic information using an interface, such as through a mobile application 502. The wholistic information can then travel through a computer network 504 such as the internet, to a pain-tracking computer 506. The computer network 504 can be any network used to connect computers together. The pain tracking computer 506 contains an interface 508 for communicating with network 504 and a controller 510 for controlling the operation of the computer.

A health care professional can also send and receive information to and from computer network 504 via a different web browser 508. Examples of browsers that can be used with the present invention include Microsoft Internet Explorer, or Google Chrome. Browsers 502 and 508 can be installed on personal computers, personal digital assistants, smart phones, or any other wireless communication devices used to access a computer network. A replay generator 520 links together time-sequenced images of pain locations on a graphical display to allow a health care professional to visually observe pain migration and intensity. The time-sequenced images can be viewed from the physician or health care professional’s browser 508 or from another device.

Pain tracking computer 506 can also alert the health care professional, or user patient, when a predetermined condition exists. For example, a health care professional may want to be alerted when the user takes a medication for more than 3 days, or if a stressor or emotional state has been logged into the system more than 3 times. An alarm limit database 522 can be located within pain tracking computer 506 and can store information relating to variables such as sleep and pain intensity and when an alert condition should be declared. Controller 510 may retrieve the information from database 522 and compare it to information provided by the user. The health care professional, user, or both may receive alert messages by communication channels such as e-mail, or text message.

In one embodiment of the claimed subject matter, the health care professional or patient may rank or provide conditions for receiving alerts through the communication channels. For example, a health care professional may decide to first receive an e-mail message and to receive a text message 2 hours later if the health care professional does not respond to the e- mail message. The health care professional or patient may also elect to be alerted or certain conditions by one communication channel and other conditions by other communication channels, or to have such alerts diverted to other individuals. The communication channel corresponds to the urgency of the alert.

Figure 6 shows a method for tracking pain migration. In step 602, the user registers via the web site, or is registered by a properly authorized individual. The registration step may also be accomplished by telephone (e.g., by speaking to an operator or to an interactive-voice- response type system); by entering information on a web page; or any other mannerthat allows pain-tracking computer 506 to obtain information from the user. The user may setup an account in step 603.

In the setup step, a user can specify pain tracking selection criteria (medications, foods, moods, stressors, etc.) as well as create user definable fields if desired. Alternatively, the selection criteria may be predefined by a health care provider, system operator or another party. The user can have their health care professional, or other authorized individuals, set up their account for them. The user may also set user preferences, such as links to family, friends, and groups. The user may choose to share their information and join forums and register for other services.

In step 604, the user enters pain information graphically through a user interface that permits the user to identify variables such as the location, intensity, characteristics of pain, and various wholistic variables such as mood and outside stressors. In step 606, the user optionally answers questions regarding their lifestyle, symptoms other than pain related symptoms, and other questions that are specific to their treatment. In step 608, the pain information for the user may be collected across a sequence of different time periods (e.g., hours, days, weeks, months, etc.) and stored in a database. The database is secure and is compliant with all medical privacy standards to protect confidential patient information. Backup copies of the database may be produced for added security.

Pain tracking computer 506 compiles the information provided by the user in step 608 and may also use algorithms designed to assist health care professionals with assessing and diagnosing a user’s conditions. Finally, in step 610 the collected pain information is displayed for the user or their health care professional, or other authorized individuals or organizations, to review. Computer executable instructions for performing the method illustrated in Fig. 6 and other disclosed methods may be stored on a computer readable medium, such as a CD-ROM.

In one embodiment of the invention, the user can identify family members or specific groups or individuals who are registered with pain tracking computer 506. Pain tracking computer 506 may then use information provided by family members or specific groups or individuals when determining which questions to ask or what information to provide. Information provided by the user can be stored in database 512. Alternatively, sensitive user information can be stored locally on the device the user uses to connect to computer network 504 to protect the user's privacy. The private information can then be retrieved when it is needed by pain tracking computer 506. In one alternative embodiment, health care professionals, or other individuals, can carry out the steps described in this paragraph, in place of the user, provided they are authorized to do so.

In an embodiment the user registers with pain tracking computer 506 and, as part of setting up his/her account, selects whether to allow his/her health care professional, or other authorized individuals, to access the entered information. The user is not required to share his/her information with a health care professional and can keep all information confidential. In one alternative embodiment, the health care professional or other authorized individuals, initially registers with pain tracking computer 506 and determines which users may utilize the services offered by pain tracking computer 506. The user can then contact pain tracking computer 506 and verify that he or she is the person authorized by the health care professional, for example, to utilize the services offered by pain tracking computer 506. Physician or health care professionals might want to control access to pain tracking computer 506 to prevent people with whom they do not have a professional relationship from utilizing the services offered by pain tracking computer 506. Users registered with pain tracking computer 506 who have selected to have their information shared with their health care professional or other authorized parlies can be listed, tracked, and updated on computer 506 to allow the health care professional or other authorized parties to better follow the user's condition.

The claimed subject matter provides a system and method that allows patients to record information such as location, intensity of pain as well as wholistic variables such as state of mind, and emotional state, which are valuable in assessing, diagnosing, and treating acute and chronic pain conditions. The information recorded by the patient will be subject to established medical standards and is designed to improve patient care and provide patients with a direct role to play in understanding and treating their pain condition.

The system can provide real-time patient monitoring that is multidimensional and wholistic in its approach. The system can provide alerts and alarms, and other forms of communication between the patient and their health care team.

The information provided by the patient may be displayed chronologically to the patient and their health care professional. The information may also be provided in graphical form indicating multidimensional factors such as emotional state, location of pain, and related information (e.g. medication usage, associated activities, time of day, quality of the pain, or resolution of the pain) over time.

The method includes the steps of receiving from a user a first set of medical information by the user during a first time and receiving from the user a second set of medical information by the user during a second time period. A health care professional or user can choose to display the information received in different formats accessible from several different locations using a web browser or on a PC, handheld device or other devices used for communicating over the Internet, or like communication channels. The displayed formats may include charts, histograms and a moving sequence of images that shows changes in the recorded information over time. The data displayed can assist physicians and health care professionals in analyzing patient data and could include feedback in the form of diagnostic considerations that would help medical professionals in conducting the proper tests used to diagnose a patient's condition. Additionally, the health care professional can set alarms within the invention, to be alerted when set limits (e.g. pain intensity, missed work days) are exceeded by their patient. This alarm can be an e-mail or text message to a predetermined address or number.

Hardware and Software Infrastructure Examples

The best mode for performing the claimed subject matter may be embodied on various computing platforms that perform actions responsive to software-based instructions and most particularly on touchscreen portable devices. The following provides an antecedent basis for the information technology that may be utilized to enable the invention.

The computer readable medium described in the claims below may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. A computer readable storage medium may be any non-transitory, tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.

A computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated signal may take any of a variety of forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A computer readable signal medium may be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device. However, claims to this invention as a software product are those embodied in a non-transitory software medium such as a computer hard drive, flash-RAM, optical disk or the like.

Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, optical fiber cable, etc., or any suitable combination of the foregoing. Computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object-oriented programming language such as Java, C#, C++, Visual Basic, Python, R or the like and conventional procedural programming languages.

Aspects of the claimed subject matter with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products are all alternative embodiments. It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general-purpose computer, special purpose computer, or other programmable data processing apparatus, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.

These computer program instructions may also be stored in a computer readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks.

The computer program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other devices to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide processes for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.

It should be noted that when referenced, an“end-user” is an operator of the software as opposed to a developer or author who modifies the underlying source code of the software. For security purposes, authentication means identifying the particular user while authorization defines what procedures and functions that user is permitted to execute.

The advantages set forth above, and those made apparent from the foregoing description, are efficiently attained. Since certain changes may be made in the above construction without departing from the scope of the invention, it is intended that all matters contained in the foregoing description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.

Claims

What is claimed is:

1. A method of quantitively and qualitatively evaluating pain the method comprising the steps of:

capturing multidimensional pain data including:

capturing speech and video data of a patient on a mobile computing device operated by the patient;

capturing self-reported pain character and medication adherence by the patient on the mobile computing device;

capturing emotional and psychological information from the patient on the mobile computing device;

automatically analyzing the speech and video data for indicia of bodily pain on the mobile computing device;

automatically analyzing the video data for face expression for indicia of bodily pain on the mobile computing device;

quantifying the indicia of bodily pain into relative values; and

reporting the relative values to a health care provider.

2. The method of claim 1 , wherein capturing speech and video data, and self-reported pain and medication adherence is collected as a first set of data during a first time period; and wherein capturing speech and video data, as well as self-reported pain and medication adherence is collected as a second set of data during a second time period; and wherein the first and second sets of data are received at a first computer coupled to a computer network and transmitted to a pain tracking computer coupled to the computer network.

3. The method of claim 2, wherein the first and second sets of data transmitted to the pain tracking computer is at a different location from the first computer.

4. The method of claim 3, wherein the first and second sets of data is accessible by a health care professional at a location difference from the location of the patient and the location of the pain tracking computer.

5. The method of claim 1 , wherein the relative values include at least two variables and wherein the at least two variables include pain characteristics, emotional and psychological, speech and video data, medications, and other symptoms.

6. The method of claim 1 , wherein the emotional and psychological information includes state of mind and mood of the patient.

7. The method of claim 5, wherein the pain characteristics include at least one of pressure, throbbing, aching, sharp, and pulling.

8. The method of claim 6, wherein the emotional and psychological information include at least one of happy, angry, depressed, anxiety, apathy, low energy, fear, stress, relaxed, tired, sad, relieved, or difficulty concentrating.

9. The method of claim 1 , wherein the patient also captures other symptoms such as fatigue, other illnesses, loss of appetite, sleep data, urination, menstrual pain and discomfort, breast tenderness, or other symptoms associated with other disease states such as diabetes.

10. The method of claim 1 , wherein the medication adherence includes the type of medication and the disease state for which it was prescribed.

11 . The method of claim 1 , wherein the speech data provides data on the quality of the

patient’s speech which can include pressured speech, muted speech, and other indicia of pain found in speech.

12. The method of claim 1 , wherein the video data provides data on the patient’s facial expressions and movements which provides information and other indicia of pain manifested in the patient’s face.

13. The method of claim 1 , further including the step of obtaining at least one alarm condition and transmitting an alert when at least one of the alarm conditions have been met.

14. The method of claim 13, wherein at least one alarm condition includes patient self- reported mood and wherein the transmitting an alert includes at least sending an e- mail message which prompts the patient or health care provider to take action; and wherein automatically analyzing the speech and video data for indicia of bodily pain, and automatically analyzing the video data for face expression for indicia of bodily pain, is on a remote computing device.

15. A computer programmed to perform the method of quantitatively and qualitatively

evaluating pain values comprising the steps of:

capturing multidimensional pain data including:

capturing self-reported pain and medication adherence by the patient;

capturing emotional and psychological information from the patient;

analyzing the speech and video data for indicia of bodily pain;

analyzing the video data for face expression for indicia of bodily pain;

quantifying the indicia of bodily pain into relative values; and reporting the relative values to a health care provider.