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Our research introduces a framework that integrates edge computing, quantum transfer learning, and federated learning to revolutionize pain level assessment through ECG signal analysis. The primary focus lies in developing a robust, privacy-preserving system that accurately classifies pain levels (low, medium, and high) by leveraging the intricate relationship between pain perception and autonomic nervous system responses captured in ECG signals. At the heart of our methodology lies a signal processing approach that transforms one-dimensional ECG signals into rich, two-dimensional Continuous Wavelet Transform (CWT) images. These transformations capture both temporal and frequency characteristics of pain-induced cardiac variations, providing a comprehensive representation of autonomic nervous system responses to different pain intensities. Our framework processes these CWT images through a sophisticated quantum–classical hybrid architecture, where edge devices perform initial preprocessing and feature extraction while maintaining data privacy. The cornerstone of our system is a Quantum Convolutional Hybrid Neural Network (QCHNN) that harnesses quantum entanglement properties to enhance feature detection and classification robustness. This quantum-enhanced approach is seamlessly integrated into a federated learning framework, allowing distributed training across multiple healthcare facilities while preserving patient privacy through secure aggregation protocols. The QCHNN demonstrated remarkable performance, achieving a classification accuracy of 94.8% in pain level assessment, significantly outperforming traditional machine learning approaches. Full article