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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","title":"Event-Aligned Analysis of Multi-Rater Pain Assessments Using Continuous Wearable Physiology","url":"https://arxiv.org/abs/2606.23705","vendor":"arxiv_cs_ai"},"summary":"arXiv:2606.23705v1 Announce Type: cross \nAbstract: 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. 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