Use of Facial Recognition Technology to Assess Drug Palatability in Pediatric Patients: A Pilot Study(Pages 37-49)

Gregory L. Kearns1, Shasha Bai2, Patricia A. Porter-Gill, Grace A. Goode3,4 and Henry C. Farrar4

1Departments of Medical Education and Pediatrics, TCU and UNTHSC School of Medicine, Fort Worth, TX, USA; 2Center for Biostatistics, The Ohio State University, Columbus, OH, USA; 3Arkansas Children’s Research Institute, Little Rock, AR, USA; 4University of Arkansas for Medical Sciences, Little Rock, AR, USA


Abstract: Palatability of oral drug formulations, especially liquids, can negatively impact therapeutic adherence in infants and children. While conventional visual analogue scales (VAS, facial Hedonic scales) are the current “gold standard” approach to assess drug palatability in adults and children, they can have significant limitations in very young children who are non-verbal or have developmentally diminished cognitive abilities. As these younger children often require administration of oral liquid drug formulations, objective methods to assess their palatability would positively impact drug development.

We undertook a prospective, pilot study to assess the feasibility of using facial recognition technology to assess drug palatability in a cohort of 10 children ranging in age from 7 to 17 years. Using a randomized, cross-over approach with washout periods, participants were administered a small dose of three test articles: Prednisone (bitter tastant), Simple Syrup USP (sweet tastant) and a proprietary pharmaceutical suspending agent (neutral tastant). After a standardized period of facial recording, participants were administered an age-appropriate visual Hedonic scale and also, were asked to describe the taste of each test article.

Qualitative assessment of the facial recognition data demonstrated that it could discriminate between the bitter and sweet tastants. Quantitative comparison revealed only a statistically significant relationship for Simple Syrup. Data from administration of the facial Hedonic scale clearly demonstrated a significant difference in the ability of study participant to discern a sweet vs. bitter taste.

Our data provide proof-of-concept for the use of facial recognition technology to assess drug palatability in older children. They also support the potential for use of this technology to assess drug palatability in younger infants and children and serve as the support to undertake these additional investigations.

Keywords: Drug, palatability, facial expression, visual analogue scales.