A picture's meaning: The design and evaluation of pictographs illustrating patient discharge instructions

Introduction: Several studies have reported that illustrations may improve patient comprehension of health communications. However, developing effective illustrations remains a challenge. To improve discharge instructions with illustrations, we developed a computer application (Glyph) that automatically converts text to pictures using natural language processing and computer graphics techniques.Methods: We evaluated a set of pictographs created for cardiovascular discharge instructions through recognition testing, and examined illustration approaches work for specific types of medical concepts and subpopulations. We tested a large set of illustrations (n = 488) on a diverse population of subjects (n = 150) for overall recognition rates by demographic groups, representation strategies, and semantic types, as well as the effectiveness of representation strategies in relationship to recognition.Results: A majority (63%) was determined to be recognizable based on recognition scores. Results were confirmed thr...