Eye-tracking enables reliable pain assessment in intubated SCI patients and is not associated with self-appraisals

Pain Manag. 2025 Oct 12:1-11. doi: 10.1080/17581869.2025.2570118. Online ahead of print.

ABSTRACT

AIMS: To examine whether eye-tracking (ET) enables reliable self-report of pain in intubated patients with spinal cord injury (SCI) and to explore associations between pain and psychological self-appraisals.

METHODS: In this prospective observational study, 75 mechanically ventilated ICU patients (46 SCI, 29 non-SCI) completed pain assessments using a Tobii Dynavox ET device. Pain was measured via the Numeric Rating Scale (NRS) and the EQ-5D-5L pain dimension. Self-esteem, anxiety, and depression were measured with the Visual Analogue Self-Esteem Scale (VASES).

RESULTS: NRS and EQ-5D pain ratings showed strong correlation (r = 0.78, p < 0.001). Pain intensity did not differ significantly between SCI and non-SCI groups. No significant associations were observed between pain and self-esteem, anxiety, or depression. A Bland – Altman plot confirmed agreement between NRS and EQ-5D pain scores.

CONCLUSIONS: ET enables reliable pain self-report in intubated ICU patients with severely limited communication. Pain ratings were independent of psychological self-appraisals, suggesting ET offers a feasible, patient-centered tool for assessing pain in this population.

PMID:41077799 | DOI:10.1080/17581869.2025.2570118