Algorithms and the Story of Black Pain.

Dr David Dunkley Gyimah
2 min readAug 24, 2024

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Finally, the get away and a much needed reboot; a walking expedition averaging 10km across various terrains in North Yorkshire sans five days social-media and phone-free. It’s all been rejuvenating.

Thank goodness too I was wearing my walking boots when I stubbed/twisted my shoe on a rock. A quick inspection showed all was well, otherwise to determine a prognosis may have required x-rays. It reminded me of a study on pain.

When it comes to pain in Black people investigative science fails to tell the whole story for treatment. Take this study into osteoarthritis pain experienced by Black patients.

Dr. Staja Booker, a nurse scientist at the University of Florida’s College of Nursing, explains that many Black individuals report significantly more intense pain than their white counterparts, even when X-ray results appear similar.

Why is that?

A study published in Nature Medicine sheds light on this disparity. Traditional methods for measuring knee pain stemmed for the Kellgren-Lawrence grade (KLG) for assessing joint damage.

Named after the two medics, and accepted by the WHO, it’s a grading system that allows doctors to make an assessment from x-ray images. That system was based on a predominantly white 1950s cohort and hence overlooked factors contributing to Black patients’ heightened knee pain.

A doctor could look at similar x-rays of two different patients, Black and white and statistically the Black patient would register more severe pain, which could baffle professionals.

Furthermore the risk exists that to codify the x-ray imagery into an algorithm that would present suitable patient care, would be erroneous and harmful. So how has this issue been addressed and how do you described the disparity in pain?

There are polymorphic reasons. Pain is wired as an intricate complex system. It’s real of course. We all know that. But it’s dependent on a person’s emotions, beliefs and expectations. It’s also contextual. If you’ve had a bad experience suffering pain, then that may affect your threshold.

In her book, how emotions are made neuroscientist Lisa Feldman Barrett explains broadly the connection between the brain and emotions. It was a must-read post-doctoral book, which I was interested in from studying cognitivist emotions in storytelling for my doctorate. That is the process of how imagery affects you. Of interest, pain and emotion share circuits in the Brain’s processing of sensations. Ergo another question thus is do Black people traditionally experience different emotion in stories? That’s for another time.

To the first question then that resolved the KLG examination, a research team led by Dr. Emma Pierson at Cornell University developed a new measure combining X-ray data with patient-reported pain levels. That is people’s own testimonials became an integral part of drug treatment. Listening to what people, Black people, said matters.

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Dr David Dunkley Gyimah
Dr David Dunkley Gyimah

Written by Dr David Dunkley Gyimah

Creative Technologist & Associate Professor. International Award Winner Cinema journalist. Ex BBC/C4News. Apple profiled Top Writer,

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