Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe
Accurate pain assessment in patients with limited ability to communicate, such as older adults with severe dementia, represents a critical healthcare challenge. Robust automated systems of pain behavior detection may facilitate such assessments. Existing pain detection datasets, however, suffer from limited ethnic/racial diversity, privacy constraints, and underrepresentation of older adults who are the primary target population for clinical deployment. We present SynPAIN, a large-scale synthetic dataset containing 10,710 facial expression images across five ethnicities/races, representing two age groups, and two genders. Using commercial generative AI tools, we created demographically balanced synthetic identities with clinically meaningful pain expressions. Our validation demonstrates that synthetic pain expressions exhibit expected pain patterns, scoring significantly higher than neutral and non-pain expressions using clinically validated pain assessment tools based on facial action unit analysis. We experimentally demonstrate SynPAIN's utility in identifying algorithmic bias in existing pain detection models. Through comprehensive bias evaluation, we reveal substantial performa
Little is known about local and systemic biomarkers in relation to synovitis and pain in end-stage osteoarthritis (OA) patients. We investigated the associations between the novel extracellular matrix biomarker, C1M, and local and systemic interleukin 6 (IL-6) with synovitis and pain. Serum C1M, plasma and synovial fluid IL-6 (p-IL-6, sf-IL-6) were measured in 104 end-stage knee OA patients. Contrast-enhanced magnetic resonance imaging (MRI) was used to semi-quantitatively assess an 11-point synovitis score; pain was assessed by the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) and the Neuropathic Pain Questionnaire (NPQ). Linear regression was used to investigate associations between biomarkers and synovitis, and biomarkers and pain while controlling for age, sex and body mass index. We also tested whether associations between biomarkers and pain were confounded by synovitis. We found sf-IL-6 was associated with synovitis in the parapatellar subregion (B=0.006; 95% CI 0.003-0.010), and no association between p-IL-6 and synovitis. We also observed an association between C1M and synovitis in the peri-ligamentous subregion (B=0.013; 95% CI 0.003-0.023). Fur
Although many people believe their pain fluctuates with weather conditions, both weather and pain may be associated with time spent outside. For example, pleasant weather may mean that people spend more time outside doing physical activity and exposed to the weather, leading to more (or less) pain, and poor weather or severe pain may keep people inside, sedentary, and not exposed to the weather. We conducted a smartphone study where participants with chronic pain reported daily pain severity, as well as time spent outside. We address the relationship between four weather variables (temperature, dewpoint temperature, pressure, and wind speed) and pain by proposing a three-step approach to untangle their effects: (i) propose a set of plausible directed acyclic graphs (also known as DAGs) that account for potential roles of time spent outside (e.g., collider, effect modifier, mediator), (ii) analyze the compatibility of the observed data with the assumed model, and (iii) identify the most plausible model by combining evidence from the observed data and domain-specific knowledge. We found that the data do not support time spent outside as a collider or mediator of the relationship betw
Chronic pain is recognized as a major health problem, with impacts not only at the economic, but also at the social, and individual levels. Being a private and subjective experience, it is impossible to externally and impartially experience, describe, and interpret chronic pain as a purely noxious stimulus that would directly point to a causal agent and facilitate its mitigation, contrary to acute pain, the assessment of which is usually straightforward. Verbal communication is, thus, key to convey relevant information to health professionals that would otherwise not be accessible to external entities, namely, intrinsic qualities about the painful experience and the patient. We propose and discuss a topic modelling approach to recognize patterns in verbal descriptions of chronic pain, and use these patterns to quantify and qualify experiences of pain. Our approaches allow for the extraction of novel insights on chronic pain experiences from the obtained topic models and latent spaces. We argue that our results are clinically relevant for the assessment and management of chronic pain.
Model Medicine is the science of understanding, diagnosing, treating, and preventing disorders in AI models, grounded in the principle that AI models -- like biological organisms -- have internal structures, dynamic processes, heritable traits, observable symptoms, classifiable conditions, and treatable states. This paper introduces Model Medicine as a research program, bridging the gap between current AI interpretability research (anatomical observation) and the systematic clinical practice that complex AI systems increasingly require. We present five contributions: (1) a discipline taxonomy organizing 15 subdisciplines across four divisions -- Basic Model Sciences, Clinical Model Sciences, Model Public Health, and Model Architectural Medicine; (2) the Four Shell Model (v3.3), a behavioral genetics framework empirically grounded in 720 agents and 24,923 decisions from the Agora-12 program, explaining how model behavior emerges from Core--Shell interaction; (3) Neural MRI (Model Resonance Imaging), a working open-source diagnostic tool mapping five medical neuroimaging modalities to AI interpretability techniques, validated through four clinical cases demonstrating imaging, compari
Pain is strongly influenced by expectations and learning from previous experience, such as in classical conditioning. Conditioned responses and expectations can generalize to perceptually and conceptually related cues, but how generalization influences pain experience and the neurobiological processing of pain remains unclear. We used fMRI and multilevel mediation analyses to address this question. Thirty-six human participants first learned to associate two visual cues from distinct conceptual categories (e.g., animals vs. vehicles) with high or low levels of heat pain. In a subsequent phase, they were presented novel cues (images, drawings, or words) not previously paired with pain, but which shared the conceptual category of the initial pain-predictive cues. Participants who developed explicit expectations during learning reported greater pain in response to stimuli conceptually related to high-vs. low-pain cues ('generalization stimuli'), demonstrating generalization of cue influences on pain. This effect was mediated by increased pain-related activity to generalization stimuli in the hippocampus, which correlated with individual differences in cue-evoked expectations. A broade
Automated pain assessment from facial expressions is crucial for non-communicative patients, such as those with dementia. Progress has been limited by two challenges: (i) existing datasets exhibit severe demographic and label imbalance due to ethical constraints, and (ii) current generative models cannot precisely control facial action units (AUs), facial structure, or clinically validated pain levels. We present 3DPain, a large-scale synthetic dataset specifically designed for automated pain assessment, featuring unprecedented annotation richness and demographic diversity. Our three-stage framework generates diverse 3D meshes, textures them with diffusion models, and applies AU-driven face rigging to synthesize multi-view faces with paired neutral and pain images, AU configurations, PSPI scores, and the first dataset-level annotations of pain-region heatmaps. The dataset comprises 82,500 samples across 25,000 pain expression heatmaps and 2,500 synthetic identities balanced by age, gender, and ethnicity. We further introduce ViTPain, a Vision Transformer based cross-modal distillation framework in which a heatmap-trained teacher guides a student trained on RGB images, enhancing acc
The question of whether insects experience pain has long been debated in neuroscience and animal behavior research. Increasing evidence suggests that insects possess the ability to detect and respond to noxious stimuli, exhibiting behaviors indicative of pain perception. This study investigates the relationship between pain stimuli and physiological responses in crickets (Gryllidae), focusing on heart rate (ECG) and brain wave (EEG) patterns. We applied a range of mechanical, chemical, thermal, and electrical stimuli to crickets, recording ECG and EEG data while employing a deep learning-based model to classify pain levels. Our findings revealed significant heart rate changes and EEG fluctuations in response to various stimuli, with the highest intensity stimuli inducing marked physiological stress. The AI-based analysis, utilizing AlexNet for EEG signal classification, achieved 90% accuracy in distinguishing between resting, low-pain, and high-pain states. While no social sharing of pain was observed through ECG measurements, these results contribute to the growing body of evidence supporting insect nociception and offer new insights into their physiological responses to external
What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins
Accurate pain expression synthesis is essential for improving clinical training and human-robot interaction. Current Robotic Patient Simulators (RPSs) lack realistic pain facial expressions, limiting their effectiveness in medical training. In this work, we introduce PainDiffusion, a generative model that synthesizes naturalistic facial pain expressions. Unlike traditional heuristic or autoregressive methods, PainDiffusion operates in a continuous latent space, ensuring smoother and more natural facial motion while supporting indefinite-length generation via diffusion forcing. Our approach incorporates intrinsic characteristics such as pain expressiveness and emotion, allowing for personalized and controllable pain expression synthesis. We train and evaluate our model using the BioVid HeatPain Database. Additionally, we integrate PainDiffusion into a robotic system to assess its applicability in real-time rehabilitation exercises. Qualitative studies with clinicians reveal that PainDiffusion produces realistic pain expressions, with a 31.2% (std 4.8%) preference rate against ground-truth recordings. Our results suggest that PainDiffusion can serve as a viable alternative to real pa
Objectives. Accurately predicting transitions to anesthetic drugs overdosage is a critical challenge in general anesthesia as it requires the identification of EEG indicators relevant for anticipating the evolution of the depth of anesthesia. Methods. In this study, we introduce a real-time, data-driven framework based on alpha spindle dynamics extracted from frontal EEG recordings. Using Empirical Mode Decomposition, we segment transient alpha spindle events and extract statistical features such as amplitude, duration, frequency, and suppression intervals. We apply these features to train a Light Gradient Boosting Machine, LGBM, classifier on a clinical EEG dataset spanning induction, maintenance, and emergence phases of general anesthesia. Results. Our model accurately classifies anesthesia phases with over 80 percent accuracy and anticipates the onset of isoelectric suppression, a marker of anesthetic drugs overdosage, with 96 percent accuracy up to 90 seconds in advance. Conclusion. The spindle-based metrics provides a non-invasive, interpretable, and predictive approach. This real-time method can be used to forecast unintentional anesthetic drugs overdosage, enabling proactive
This study examines the clinical decision-making processes in Traditional East Asian Medicine (TEAM) by reinterpreting pattern identification (PI) through the lens of dimensionality reduction. Focusing on the Eight Principle Pattern Identification (EPPI) system and utilizing empirical data from the Shang-Han-Lun, we explore the necessity and significance of prioritizing the Exterior-Interior pattern in diagnosis and treatment selection. We test three hypotheses: whether the Ext-Int pattern contains the most information about patient symptoms, represents the most abstract and generalizable symptom information, and facilitates the selection of appropriate herbal prescriptions. Employing quantitative measures such as the abstraction index, cross-conditional generalization performance, and decision tree regression, our results demonstrate that the Exterior-Interior pattern represents the most abstract and generalizable symptom information, contributing to the efficient mapping between symptom and herbal prescription spaces. This research provides an objective framework for understanding the cognitive processes underlying TEAM, bridging traditional medical practices with modern computat
Chronic pain is a widespread and debilitating condition that affects millions of individuals worldwide. Recent research has unveiled a connection between chronic pain and epigenetic processes, shedding light on the complex interplay between genetics, environment, and pain perception. This review synthesizes findings from several studies exploring the relationship between epigenetic modifications, pain intensity, disability, and various other factors in individuals with chronic pain. The studies encompass a range of chronic pain conditions, including chronic low back pain, knee osteoarthritis pain, and pain in the context of underlying health conditions. The review highlights key findings and implications from each study and discusses their collective contributions to our understanding of the epigenetic mechanisms underpinning chronic pain.
Background. Chronic pain afflicts 20 % of the global population. A strictly biomedical mind-set leaves many sufferers chasing somatic cures and has fuelled the opioid crisis. The biopsychosocial model recognises pain subjective, multifactorial nature, yet uptake of psychosocial care remains low. We hypothesised that patients own pain narratives would predict their readiness to engage in psychotherapy. Methods. In a cross-sectional pilot, 24 chronic-pain patients recorded narrated pain stories on Painstory.science. Open questions probed perceived pain source, interference and influencing factors. Narratives were cleaned, embedded with a pretrained large-language model and entered into machine-learning classifiers that output ready/not ready probabilities. Results. The perception-domain model achieved 95.7 % accuracy (specificity = 0.80, sensitivity = 1.00, AUC = 0.90). The factors-influencing-pain model yielded 83.3 % accuracy (specificity = 0.60, sensitivity = 0.90, AUC = 0.75). Sentence count correlated with readiness for perception narratives (r = 0.54, p < .01) and factor narratives (r = 0.24, p < .05). Conclusion. Brief spoken pain narratives carry reliable signals of wil
Understanding pain-related facial behaviors is essential for digital healthcare in terms of effective monitoring, assisted diagnostics, and treatment planning, particularly for patients unable to communicate verbally. Existing data-driven methods of detecting pain from facial expressions are limited due to interpretability and severity quantification. To this end, we propose GraphAU-Pain, leveraging a graph-based framework to model facial Action Units (AUs) and their interrelationships for pain intensity estimation. AUs are represented as graph nodes, with co-occurrence relationships as edges, enabling a more expressive depiction of pain-related facial behaviors. By utilizing a relational graph neural network, our framework offers improved interpretability and significant performance gains. Experiments conducted on the publicly available UNBC dataset demonstrate the effectiveness of the GraphAU-Pain, achieving an F1-score of 66.21% and accuracy of 87.61% in pain intensity estimation.
The limited size of pain datasets are a challenge in developing robust deep learning models for pain recognition. Transfer learning approaches are often employed in these scenarios. In this study, we investigate whether deep learned feature representation for one type of experimentally induced pain can be transferred to another. Participating in the AI4Pain challenge, our goal is to classify three levels of pain (No-Pain, Low-Pain, High-Pain). The challenge dataset contains data collected from 65 participants undergoing varying intensities of electrical pain. We utilize the video recording from the dataset to investigate the transferability of deep learned heat pain model to electrical pain. In our proposed approach, we leverage an existing heat pain convolutional neural network (CNN) - trained on BioVid dataset - as a feature extractor. The images from the challenge dataset are inputted to the pre-trained heat pain CNN to obtain feature vectors. These feature vectors are used to train two machine learning models: a simple feed-forward neural network and a long short-term memory (LSTM) network. Our approach was tested using the dataset's predefined training, validation, and testing
Pain is among the most salient of experiences while also, curiously, being among the most malleable. A large body of research has revealed that a multitude of explicit strategies can be used to effectively alter the attention-demanding quality of acute and chronic pains and their associated neural correlates. However, thoughts that are spontaneous, rather than actively generated, are common in daily life, and so attention to pain can often temporally fluctuate because of ongoing self-generated experiences. Classic pain theories have largely neglected to account for unconstrained fluctuations in cognition, but new studies have demonstrated the behavioral-relevance, putative neural basis, and individual variability of interactions between pain and spontaneous thoughts. In this chapter, I review behavioral studies of ongoing fluctuations in attention to pain, studies of the neural basis of spontaneous mind-wandering away from pain, and the clinical implications of this research.
The Oxford English Dictionary defines precision medicine as "medical care designed to optimize efficiency or therapeutic benefit for particular groups of patients, especially by using genetic or molecular profiling." It is not an entirely new idea: physicians from ancient times have recognized that medical treatment needs to consider individual variations in patient characteristics. However, the modern precision medicine movement has been enabled by a confluence of events: scientific advances in fields such as genetics and pharmacology, technological advances in mobile devices and wearable sensors, and methodological advances in computing and data sciences. This chapter is about bandit algorithms: an area of data science of special relevance to precision medicine. With their roots in the seminal work of Bellman, Robbins, Lai and others, bandit algorithms have come to occupy a central place in modern data science ( Lattimore and Szepesvari, 2020). Bandit algorithms can be used in any situation where treatment decisions need to be made to optimize some health outcome. Since precision medicine focuses on the use of patient characteristics to guide treatment, contextual bandit algorith
Unaddressed pain in neonates can lead to adverse effects, including delayed development and slower weight gain, emphasising the need for more objective and reliable pain assessment methods. Hence, automated methods using behavioural and physiological pain indicators have been developed to aid healthcare professionals in the Neonatal ICU. Traditional contact-based methods for physiological parameter estimation are unsuitable for long-term monitoring and increase the risk of spreading diseases like COVID-19. We introduce a novel approach using remote photoplethysmography (rPPG) to estimate pulse signals in a non-contact manner and employ them for neonatal pain detection. The temporal signals acquired from regions-of-interest (ROIs) affected by skin deformations may exhibit lower quality and provide erroneous rPPG signals. Therefore, we incorporated a quality parameter to select the temporal signals obtained from ROIs that are least affected by skin deformations. Further, we employed signal-to-noise ratio as a fitness parameter to extract the rPPG signal corresponding to the clip that is least affected by noise. Experimental findings demonstrate that the rPPG signals provide useful in