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arXiv · 2606.23705

Event-Aligned Analysis of Multi-Rater Pain Assessments Using Continuous Wearable Physiology

Saba A. Farahani·Elahe Khatibi·Thomas D. Hughes·Ariana M. Nelson·Hung Cao·Amir M. Rahmani
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Abstract

Pain is assessed differently by patients, nurses, and clinicians, yet most computational approaches assume a single ground-truth label - effectively ignoring who is doing the rating. We introduce a rater-aware, event-aligned framework that converts sparse, rater-specific pain ratings into discrete pain-change events and aligns continuous wearable physiological signals to these events, preserving rater identity throughout. Applied to multimodal wearable data collected during spine-related pain procedures, the framework identifies substantial disagreement across rater groups and provides preliminary, exploratory evidence of rater-dependent physiological differences preceding reported pain increases. These findings suggest that pain-physiology relationships may not be rater-invariant, and that aggregating assessments across raters may mask meaningful physiological patterns. A rater-aware, event-aligned perspective is therefore a promising direction for interpreting wearable data in real-world clinical pain assessment.

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Saba A. Farahani, Elahe Khatibi, Thomas D. Hughes, Ariana M. Nelson, Hung Cao, Amir M. Rahmani. 2026-08-31. Event-Aligned Analysis of Multi-Rater Pain Assessments Using Continuous Wearable Physiology. https://arxiv.org/abs/2606.23705

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