Texas Tech University

Psychology Researcher Developing Culturally Informed Pain Diagnosis Technology

TTU Office of Communications & Marketing

February 8, 2021

With help from the Innovation Hub at Research Park, Shin Ye Kim and her team are bringing CIPDAR to life.


When Shin Ye Kim came from South Korea to the U.S. 11 years ago as a master's student in psychology, she expected to work closely with people who have mental health issues. She never anticipated working with those in physical pain, because the two were completely separate in her mind.

But while working toward her doctorate several years later, she began providing individual and group psychotherapy to hundreds of chronic pain patients in a Wisconsin clinic.

"Until my time in that pain clinic, my idea of pain was very confined to the physical realm," explained Kim, a licensed psychologist and assistant professor in the Texas Tech University Department of Psychological Sciences. "Then, by working with patients and their families and seeing how powerful psychological interventions are for those with chronic pain, I was amazed by the deep connection between mind and body.

"From that point on, pain was never again just physical. I came to understand pain as something that is physical, social, psychological, and cultural. All of these elements impact patients' lives."

Kim recognized the connections between patients' physical pain and their psychological pain, trauma, their emotions, and their social and cultural norms and expectations. She learned that persistent pain differs by individual and considering their cultural and familial norms and expectations can make assessment and treatment even more complex.

Language barriers further exacerbate these issues, a lesson Kim understood deeply and personally. As a student, she often felt frustrated she couldn't use the equivalent descriptive words in English that she would have in Korean – some had no exact translation, and others simply didn't exist in English.

"Making matters even more difficult is the added fact that patients have very little time with their physicians," she added. "Trying to urgently and succinctly communicate the language of pain in a new language adds stress and burden to linguistic minority patients."

A decade later, Kim's experiences culminated in the creation of Culturally Informed Pain Diagnosis and Relief (CIPDAR), an innovative technology that provides multilingual, multimodal and multidimensional pain assessment and management for linguistically and culturally diverse patients.

"Our passion for helping chronic pain patients unites our team and motivates our work. We draw our inspiration from the recognition that underserved and marginalized patient groups have greater difficulty communicating their pain to providers because of the very subjective nature of pain, which negatively affects accurate diagnosis and effective treatment," Kim said.

"We are interested in developing technology that provides patients and providers a pathway to more effective pain communication, which will help facilitate more accurate diagnoses and better patient outcomes. Our technology aims to overcome language and cultural barriers that can impede the diagnostic and treatment process of chronic pain."

Beyond mere language translation, CIPDAR incorporates culturally relevant pain terms, phrases, patterns and questions to improve doctor-patient communication. Pain is assessed through both patients' self-reports and by analyzing their nonverbal behaviors, such as gestures, movements and facial expressions. It also provides patients with pain-management interventions and education, including tools that address time management, medication tracking and work-family balance.

Now, Kim and two counseling psychology doctoral students, Hannah Yoo and Nguyen Nguyen, are working to bring CIPDAR to fruition, with help from the Innovation Hub at Research Park. Yoo brings in experience in behavioral health care research, community-based interventions and leveraging technology to enhance the health outcomes of underserved groups, while Nguyen has extensive experience in investigating the critical communication issues at the intersection of culture and language underlying their project.

Phil Sizer is an endowed professor of pain science in the Texas Tech University Health Sciences Center with more than 35 years of clinical pain management experience. He's also an entrepreneur – the founder and CEO of TKQuant LLC and a co-inventor of the patented Tis-Kin™ technology.

With Sizer as the team's industry mentor, Kim as the technical lead and Yoo and Nguyen as co-entrepreneurial leads, the CIPDAR team went through the regional NSF I-Corps program in the fall.

"Regional NSF I-Corps was an enriching learning opportunity that challenged many of our traditional ways of thinking as researchers," Kim said. "The program tasked us to look beyond the focused goals of our research lab and start thinking about the real-world applicability of behavioral health psychology."

During regional NSF I-Corps, Yoo and Nguyen investigated the commercial landscape, helping the team gain critical customer insights.

"Using our own networks, as well as doing quite a bit of cold calling, we interviewed 38 potential customers, including healthcare professionals and bilingual chronic pain patients both locally and across the nation," Kim said. "Throughout the process of speaking to potential customers, we continuously refined our interview questions and our understanding of the customers' pain points. We were constantly asking ourselves, 'Is the problem what we thought it was?' and 'Is the problem urgent enough for customers to need a solution?'"

Together, they analyzed information gathered from those interviews to further refine the product and its business concept. At the same time, Kim submitted the invention disclosure to the Texas Tech Office of Research Commercialization. After being evaluated for patentability, the concept was deemed a novel approach to pain diagnosis, and one for which a strong market exists.

At the end of three weeks, they presented their results.

"Most insights we heard from potential customers validated our understanding of the core problem: Chronic pain is inherently difficult to communicate, treat and diagnosis, and it is even more challenging for limited English-proficient patients," Kim said. "However, we found that health care providers perceived it as more urgent of an issue than patients did, and some patients were content with the care they received.

"We were surprised by this, considering that both health care providers' insights and the data indicate that limited English-proficient patients are vulnerable to longer, ineffective treatments for chronic pain. This discrepancy highlighted the importance of our patient-centered model – our product has the potential to empower patients, equipping them with tools to become advocates for their own health, rather than remaining passive participants in the health care setting."

After integrating their results from the regional NSF I-Corps program, the CIPDAR team applied for the NSF I-Corps national program. After preparing as much as possible, even doing mock interviews, the team interviewed for real in December.

"The interview was extremely straightforward, and that same day, we received an email from a National Science Foundation (NSF) representative that we were accepted into the national program," Kim said. "We were told from several NSF I-Corps faculty from different institutions that it was very rare that we heard from NSF the same day, because the process typically involves another interview with other NSF administrators after first-round interviews.

"Needless to say, we were honored by this acceptance and are excited that psychology is viewed as a partner in pain science."

The CIPDAR team will participate in the national NSF I-Corps program from late March through May.

"As a team, we are incredibly grateful to have this opportunity and engage in interdisciplinary work, leveraging research outside the laboratory," Kim said. "We are eagerly anticipating the start of the program, as it will be an intense, transformative eight weeks. Although balancing our responsibilities will be tough, we are prepared to take on the challenges and explore the commercial viability of this technology.

"Above all else, we would all like to thank everyone who has been and continues to be so helpful and encouraging. We appreciate the tremendous support from Innovation Hub faculty and staff. I want to extend a special thanks to the previous program director, Weston Waldo, who encouraged me to pursue this idea when I doubted myself because I previously believed programs like this were not applicable to my field. Lastly, I want to express my utmost gratitude to my graduate students Yoo and Nguyen. I am enormously proud of their exceptional work and level of commitment to this project."