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  ARM Give a man a fire and he's warm for a day, but set fire to him and he's warm for the rest of his life (Terry Pratchett, Jingo)

Why tell the doctor where it hurts, when you could use emoji instead?

(2021/09/09)


Doctors could soon use emoji, those love-them-or-hate-them colourful successors to the humble emoticon, to communicate with patients and ease their diagnosis and recovery – or, if you prefer, 👨‍⚕️🗣️🖼️🤒🚑🏥🩺🤕.

"It's tempting to dismiss emoji as a millennial fad, but they possess the power of standardisation, universality and familiarity," claimed Shuhan He, MD and senior author of the commentary piece highlighting the potential of the colourful icons, "and in the hands of physicians and other health care providers could represent a new and highly effective way to communicate pictorially with patients.

"The need to listen to patients is at the core of our mission as physicians, and the use of emoji is a great opportunity to take communication to another level. Emoji could be particularly important in treating children with still-developing language skills, people with disabilities that impair their ability to communicate, and the many patients who speak a different language."

[1]

He and colleagues identified "roughly 30" emoji characters, of the 3,521 registered in the Unicode standard at the time of investigation, which "could be considered relevant to medicine" - not counting generic images of people and body parts, nor the ever-popular double-entendre of the "eggplant" emoji.

[2]

[3]

The additions most recently celebrated are the emojis for an anatomical heart and lungs, over which He and co-author Debbie Lai, BA, worked alongside a member of the National Health Service (NHS) to see their inclusion in the standard. Since then, a further 15 medical emojis – including intestines, a leg cast, spine, blood bag, IV bag, weight scale, and crutches – have been proposed to the Unicode Consortium (although not yet added).

Using these, the researchers argue, written discharge instructions could be augmented to make those instructions easier to understand amongst patients with lower health literacy – while using the iconography for point-and-tap communication could break down language barriers and speed diagnoses.

[4]The unit of measure for fatbergs is not hippopotami, even if the operator of an Australian sewer says so

[5]'No peeing towards Russia' sign appears on country's Arctic border with Norway

[6]Magna Carta mayhem: Protesters lay siege to Edinburgh Castle, citing obscure Latin text that has never applied in Scotland

[7]Dry patch? Have you considered peppering your flirts with emojis?

"The medical community should begin to work toward consensus on what iconography would best serve patients and the profession with the goal of improving the accessibility and quality of health care and health information in the digital age," the report concludes.

"Physician organisation committees tasked with managing the submission of and advocacy for medical emoji would fill a current vacuum, where there is no formal process for proposing and evaluating medical emoji. Such a dedicated effort would enable diverse medical practitioners to participate in the process and influence the evolution of a clinically and demographically representative set of images for widespread use."

[8]

Co-author Jennifer 8. Lee, meanwhile, has form in attempting to expand the emoji landscape: she is the founder – and, according to a conflict of interest disclosure, "unpaid volunteer" – of [9]Emojination , a self-described grassroots group which aims to improve representation in the Unicode standard and claims to be directly responsible for the addition of over 100 emojis since its formation, including interracial couple, bubble tea, llama, and toothbrush.

The commentary, Emoji for the Medical Community - Challenges and Opportunities , has been published under open-access terms in the [10]Journal of the American Medical Association . ®

Get our [11]Tech Resources



[1] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/front&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=2&c=2YTovv4qNa1iZ0UmOwEgVDAAAAMU&t=ct%3Dns%26unitnum%3D2%26raptor%3Dcondor%26pos%3Dtop%26test%3D0

[2] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/front&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44YTovv4qNa1iZ0UmOwEgVDAAAAMU&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0

[3] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/front&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33YTovv4qNa1iZ0UmOwEgVDAAAAMU&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0

[4] https://www.theregister.com/2021/09/02/sewer_hippo_outrage/

[5] https://www.theregister.com/2021/08/26/no_peeing_towards_russia_sign/

[6] https://www.theregister.com/2021/08/18/magna_carta_edinburgh_castle/

[7] https://www.theregister.com/2019/08/19/emojis_get_you_laid/

[8] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/front&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44YTovv4qNa1iZ0UmOwEgVDAAAAMU&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0

[9] http://www.emojination.org/

[10] https://jamanetwork.com/journals/jama/fullarticle/2783847

[11] https://whitepapers.theregister.com/



History repeats itself

ThatOne

So we're heading back to hieroglyphs... The writing was on the wall for some time.

Sure, it is easier to understand the picture of a duck than to remember what the abstract symbols "d"+"u"+"c"+"k" might mean, it also goes with the general dumbing-down simplification of peoples' though processes. With an emoji language you can't convey complex thoughts, and simple "eat"-"LOL"-"heart!" people are easier to manipulate keep happy.

Re: History repeats itself

ibmalone

""It's tempting to dismiss emoji as a millennial fad, but they possess the power of standardisation, universality and familiarity," claimed Shuhan He, MD"

I also don't buy it, see the mentioned eggplant. Emoji are not displayed uniformly across devices and interpretation of their meaning relies on the interplay between their appearance and cultural context. Hence innocent fruit and vegetables become suggestive. "Sure," you think, "People will always find ways to be rude with turnips." That little snorting smiley face that to most westerners looks angry? It was originally "Triumph" in Japan.

Egypt moved away from purely ideographic hieroglyphics, they came to be used for syllables and more generic ideas. Heiroglyphs were later on limited to cermonial use, for a long time it coexisted with the more day-to-day hieratic script. Chinese has similar ideographic roots, yet most characters no longer resemble the thing they represent, even when that was their original derivation (to pick one from my almost non-existent knowledge of Chinese, horse is just about recognisable as a horse in traditional script, and not really in simplified script). The one thing emoji have going for them if they want to endure is reliability in reproduction, while Chinese and Hieroglyphic scripts written by hand required lengthy training to reproduce.

Re: History repeats itself

Anonymous Coward

My wife recently got some noise-cancelling Bluetooth headphones. The instructions are almost entirely pictorial. Some of those are helpful - a Morse-code-like illustration of the blink pattern when it's trying to connect, for instance - but overall it's rather sad. Give me actual written directions any day!

(Why pictorial? Probably so they don't have to pay for translations.)

Re: History repeats itself

heyrick

There's a machine at work with various warning signs on it, and I swear one of them looks like it means "only one person can shag this machine at a time". Given it's a health and safety warning, it's worrying that I genuinely have no idea what it is trying to say.

Re: History repeats itself

ThatOne

> Why pictorial?

Because they don't expect their potential clients to have mastered reading.

No, this isn't a quip, sadly, accessibility to illiterate people is the main argument for the ever increasing use of pictograms instead of written language. And since more and more people are illiterate (to some extent)...

Re: History repeats itself

Anonymous Coward

I have found pictograms useful because sometimes it's the people writing the instructions that appear to be illiterate!

Now if only manufacturers would provide pictograms drawn by someone who has actually seen the product in question...

"accessibility to illiterate people is the main argument for the ever increasing use of pictograms"

Pascal Monett

Great. Illiteracy is a growing problem.

Solution ? Instead of putting in the effort to curb illiteracy, let's make everyone more stupid.

Wonderful. Civilization really is going places.

Mainly down, but still, we're going places.

Re: History repeats itself

William Towle

Nod.

I recently had the interesting experience of setting up a brand new monitor where the instructions were entirely pictorial.

Naturally en route to getting at the instructions, I took everything out of the box only for the first frame to convey the idea -eventually, I realised- that you connected the head of the stand with the screen in the box, still wrapped and face down, in order to protect it.

Then you connected the base by pushing and turning, followed by the tightening of screws, and *only then* would it tilt, raise/lower, or turn as expected. It needed to say so - I sat with the base half on and rotated at 45 degrees wondering what I'd done wrong for some minutes!...

Re: History repeats itself

Andy Non

Instructions? You got instructions you could actually see? Too often nowadays any written instructions I receive with products are in text so tiny as to be utterly useless short of a microscope to read them.

Re: History repeats itself

TeeCee

Except, of course, that the reason it took so long to decipher hieroglyphic was entirely due to the misconception that the language was either ideographic or pictographic.

Hieroglyphs represent phonemes.

Now, if you'd gone with Chinese, or Mayan, or (etc ad nauseum) you'd have had a point.

Re: History repeats itself

Anonymous Coward

In modern Chinese, it's largely not the case either. Only a few characters are somewhat ideographic, like 山 or 伞. But the meaning of single characters has long diverged from the sum of their components, and words are composed of multiple sounds, not the meaning of their character components.

Re: History repeats itself

ThatOne

> Now, if you'd gone with Chinese, or Mayan, or (etc ad nauseum) you'd have had a point.

Sorry, can't determine who you're talking to. If it was me, I wrote "hieroglyphs" meaning "pictographic logograph", because I didn't expect everybody around to know what a "logograph" is, but everybody is bound to know what hieroglyphs are (i.e. pictures meaning words).

It is true that logographies are impossible to use as such alone, sooner or later you need to encode more abstract notions like sounds for which there is no possible image. Mayan glyphs also occasionally encoded syllables. And at some point in the distant future, emojis will start encoding syllables too...

Re: History repeats itself

Anonymous Coward

It's easier only if you already know what a duck looks like, and if the emoji on whatever device you're using is matching the sort of duck you know.

Now, I kind of liked the idea, but then, it seems a little optimistic to hope that people who don't know how to read will know well enough what a heart or lungs look like to match it with a stylized emoji. Even most educated people can't even place precisely their organs.

And then there's scale. Will the emoji of the liver be the same size as one for the kidneys?

I suppose they'll have to work on that.

Re: History repeats itself

Paul Herber

Also compare emoji sizes for testicle and brain.

Idiocracy

DJV

It wasn't meant to be a documentary, was it?

[1]https://www.imdb.com/title/tt0387808/

[1] https://www.imdb.com/title/tt0387808/

Re: Idiocracy

Pascal Monett

No, but here we are.

Re: Idiocracy

Throatwarbler Mangrove

Sure, Not

Accessibility Fail.

ShadowSystems

Pictures are worth *zero* words to the blind, so how do you propose to make someone whom can't see your pretty pictures use said images to convey anything at all?

My screen reader goes silent when it comes across one, I get SFA if I try to select one, and a "character map" style interface is pointless since it's a purely visual-only means of interaction -- I can't select a specific icon if the screen reader can't read the icon in the first place.

Re: Accessibility Fail.

ibmalone

Ohhh, interesting point, following on from my other post, people interpret on their appearance. There's no reason a screen reader couldn't read out the emoji name for you, but that may not always match what a sighted person would interpret the pictorial form to mean.

Re: Accessibility Fail.

Anonymous Coward

This is an excellent point. Pictorial systems can work pretty well for people who have trouble communicating verbally due to language differences or disabilities, but are a complete and total failure for folks who have poor or no vision. Verbal or written (via screen reader) should always be available because of this.

Can't please everyone with a single solution

Flocke Kroes

This is a reasonable solution for when a doctor and sighted patient do not have a common language. I would go with clip art on paper but that is less good for a COVID compatible consultation by phone.

For blind and no common language perhaps google translate and a screen reader does something useful.

Literacy & numeracy

KarMann

Co-author Jennifer 8. Lee… I assume she's related to Tom Lehrer's good friend, Hen3ry? (The '3' is silent.)

The Boak

HPCJohn

My father worked in a research unit in Gastrointestinal medicine in Glasgow. They were pioneers before their time in what we now call expert systems as applied to medicine. They found that people would be more open and honest in giving answers to GI symptoms when asked by computer.

HE tole me that when foreign doctors (read English too) came to Glasgow they had to be given language coaching 'A huv the dry boak doctor'

Intelligibility fail

heyrick

The second to last square of each emoji sequence appears as a black square on my phone. This could be the difference between being prescribed a bottle of Prozac, or having a kidney removed...

Re: Intelligibility fail

Yet Another Anonymous coward

I think black square is plague

Re: Intelligibility fail

ThatOne

> appears as a black square on my phone

You obviously need to buy a new phone: Healthy people have the newest [model you clearly don't have].

Re: Intelligibility fail

Gene Cash

On my machine, it's some sort of snake thing. Or maybe a worm? In front of it is some sort of salad colander? I don't know why that's there.

Re: Intelligibility fail

2+2=5

> On my machine, it's some sort of snake thing

"No doctor, I don't want you to listen to my chest through your stethoscope, I want you to deal with my tapeworm."

Re: Intelligibility fail

Sceptic Tank

The doctor turned gray and coughed on my painting. I rearranged his face and he is in an ambulance at the petrol station. The conjoined snake twins stare deeply into their own eyes and there is snow on my forehead.

Can't see how anyone can get that wrong.

Yes, we're all anti-american terrorists who plan to make the
US economy collapse by inventing lots of new words which will
have to be added to the dictionary, making the US economy
unable to support the ever-growing dictionaries and ensuring
the Americans will be unable to (learn to) spell, leaving them
dead in the water if there's ever a linguistic war between
them and the UK.

- Rik van Riel explaining the real reason behind spelling
mistakes in the linux kernel