Feasibility of the Rule-Based Approach to Creating Complex Pictograms.

To test the effectiveness of the health pictograms created based on the pictogram composite rules, we created 7 new composite pictograms following the composite rules extracted from the USP pictograms. We then tested their understandability by surveying 42 volunteers recruited at a senior wellness center in San Diego, CA. Lower level of comprehension was observed in all 7 new composite pictograms when compared to the USP pictograms with similar styles. No consistent socio-demographic effect on the comprehension of the pictograms was discerned. The major sources of misinterpretations were (1) misunderstanding the main action depicted in the image, (2) ignoring the conditional information, and (3) making an incorrect semantic association between the main information and the conditional information. Design rules from the validated set of pictograms might serve as the starting point for creating a new health pictogram. However, rigorous validation and revision of the initial design should follow.