NAMRU San Antonio conducts Quantitative Detection of Pain Study

US Navy | 2022-03-14

By Burrell Parmer

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, TEXAS: Dental health and readiness is crucial in the military health system. To increase readiness, researchers assigned to Naval Medical Research Unit (NAMRU) San Antonio have been conducting a study for the Electrodermal Activity Sensing for Quantitative Detection of Pain.

Stephanie Speaker (right), of West Warwick, R.I., a biomedical engineer from the Naval Undersea Warfare Center, conducts a practice test for the Electrodermal Activity Sensing for Quantitative Detection of Pain on Katie Geary, of Belcamp, Md., a research engineer with Naval Medical Research Unit (NAMRU) San Antonio at the Battlefield Health and Trauma Building 2 located next to the Brooke Army Medical Center while Cmdr. Rachel Werner, of Cocoa Beach, Fla., head of NAMRU San Antonio’s Maxillofacial Injury and Disease Department, observes. (U.S. Navy photo by Burrell Parmer, Naval Medical Research Unit San Antonio Public Affairs/Released)'

According to Cmdr. Drew Havard, of Gulfport Miss., NAMRU San Antonio’s deputy director for Craniofacial and Restorative Medicine, electrodermal activity is fluctuations in the electrical characteristics of the skin, typically controlled by the sweat glands.

“More sweat means more skin conductance and thus more electrodermal activity,” said Havard. “When you start to get anxious or are in a state of discomfort, your palms are typically sweaty or clammy. We believe that a machine learning algorithm can be trained to distinguish between pain and anxiety based on this activity to help dental care providers provide optimal care to their patients.”

“This tool would potentially help distinguish pain from anxiety to allow providers to better treat patients,” he said.

“Accurate determinations of pain will lead to a more appropriate use of pain medications and therefore will increase patient safety and potentially lower costs. Anxiety may also be determined and addressed making patients more likely to participate in routine care before dental emergencies occur,” said Havard.

The success of the study, which began in 2019, is dependent upon volunteers.

According to Katie Geary, of Belcamp, Md., a research engineer with NAMRU San Antonio, the study has tested 45 subjects with the objective of testing 35 more.

“The more volunteers we can recruit for this project, the better our final product will be,” said Geary, who has been actively working in the field of Biomedical Engineering since 2015. “Machine learning algorithms are only as “smart” as the data they are trained on allows them to be. The more subjects we recruit, the larger our data pool to train from and the better our final algorithm will be at making an educated guess as to how patients are feeling.”

As the project is still in the data collection and preliminary algorithm training phase, NAMRU San Antonio expects it to be deployed for clinical testing in 2023.

Referred to as the “EDAPS” program, the system would be deployed in all Department of Defense (DoD) dental facilities after development and testing.

There are seven NAMRU San Antonio team members on the project to include Havard, Geary, Jacqueline Villanueva, Justin Bequette, Dr. William D’Angelo, Cmdr. Leslie Trippe, and Cmdr. Rachel Werner. Additional support is being provided by Stephanie Speaker, a biomedical engineer from the Naval Undersea Warfare Center who is temporarily assigned to NAMRU San Antonio. The team also collaborates with Dr. Ki Chon from the University of Connecticut and members of his laboratory: Dr. Hugo Posada-Quintero, Youngsun Kong, and Andrew Peitzsch.

The procedures in this study are designed to create the illusion of pain in one phase and slight discomfort the second phase without creating any real damage to the patient.

All procedures in this study have been evaluated by the NAMRU-SA Institutional Review Board and determined to be safe.

The study includes 30 to 40 minutes of a subject’s time and is conducted on Tuesdays and Fridays at the Battlefield Health and Trauma Building 2 located next to the Brooke Army Medical Center until March 31. Alternate days can be accommodated.

Volunteers may include DoD ID card holders and family members of NAMRU San Antonio, Navy Medicine Training Support Center, U.S. Army Institute of Surgical Research, Air Force 59th Medical Wing and 711th Human Performance Wing.

To volunteer for the study, email NAMRU San Antonio Public Affairs Office at usn.jbsa.namrusanantoniotx.mbx.pao@mail.

NAMRU San Antonio’s mission is to conduct gap driven combat casualty care, craniofacial, and directed energy research to improve survival, operational readiness, and safety of Department of Defense personnel engaged in routine and expeditionary operations.

It is one of the leading research and development laboratories for the U.S. Navy under the DoD and is one of eight subordinate research commands in the global network of laboratories operating under the Naval Medical Research Center in Silver Spring, Md.