Pictograph system for diagnosis making and data management in endodontics / Sistema de pictograma para elaboração de diagnóstico e gerenciamento de dados em endodontia

Objective: this questionnaire aimed to evaluate the approval of a new pictograph system for endodontic diagnosis by undergraduate and graduate students/endodontist instead of a conventional method. Methods: after a presentation to a total of 224 participants explaining the pictograph system, the participants (166 undergraduate students and 58 graduate students/endodontist) received a standardized questionnaire with three questions. The data were analyzed using the mult prop macro basing on Tukey's test for multiple comparison with (P ≤ 0.05). The first question was to define the education level of the participants; the second question about which diagnosis method is preferred; and the third question about the intention of using one of the methods in the future. The questionnaire was realized in May 2019. The response rate was 97.7%. Results: the first question showed that 74.10% and 25.90% were under graduate and graduate students/endodontist respectively. After statistical analysis there was no significant difference between the groups in the second and the third questions. In the second question (71.08% and 62.06%) of undergraduate and graduate student/endodontists respectively preferred the pictograph method over the conventional method. In the third question (60.24% and 51.72%) of undergraduate and graduate student/endodontists respectively showed interest in using the pictograph method in their professional career. Conclusion: the pictograph method in endodontic diagnosis is accepted by the majority of undergraduate and graduate students/endodontists. Training and experience affect the diagnosis making. (AU)

Objetivo: este questionário teve como objetivo avaliara aprovação de um novo sistema de imagem para diagnóstico endodôntico por estudantes de graduação e pós-graduação/endodontista, em vez de um método convencional. Métodos: após uma apresentação a um total de 224 participantes explicando o sistema de pictograma, os participantes (166 estudantes de graduação e 58 de pós graduação/endodontista) receberam um questionário padronizado com três perguntas. Os dados foram analisados usando a macro multi propósito baseada no teste de Tukey para comparação múltipla com (P ≤ 0,05). A primeira pergunta foi definir o nível de escolaridade dos participantes; a segunda pergunta sobre qual método de diagnóstico é preferido; e a terceira pergunta sobre a intenção de usar um dos métodos no futuro. O questionário foi realizado em maio de 2019. A taxa de resposta foi de 97,7%. Resultados: a primeira pergunta mostrou que 74,10% e 25,90% eram estudantes de graduação e pós-graduação / endodontista, respectivamente. Após análise estatística, não houve diferença significativa entre os grupos na segunda e na terceira questões. Na segunda questão (71,08% e 62,06%) dos estudantes de graduação e pós-graduação / endodontistas, respectivamente, preferiram o método de pictograma ao método convencional. Na terceira questão (60,24% e 51,72%) dos estudantes de graduação e pós-graduação /endodontistas, respectivamente, demonstraram interesse em utilizar o método de pictograma em sua carreira profissional. Conclusão: o método do pictograma no diagnóstico endodôntico é aceito pela maioria dos estudantes de graduação e pós-graduação / endodontistas. Treinamento e experiência afetam a elaboração do diagnóstico (AU)

A Picture Is Worth a Thousand Words: Pictographs to Improve Understanding of Discharge Instructions.

INTRODUCTION: Poor comprehension of ED discharge instructions has been reported. Discharge instructions often include written information. Identification of home-care practices that were different from recommended discharge instructions among multiple clients led nurses at a community emergency department to evaluate health literacy among specific clients. METHODS: A bilingual translator administered the Newest Vital Sign-a 6-item validated scale that assesses health care literacy-to 150 English and Spanish-speaking parents of pediatric patients admitted to the fast-track area. RESULTS: Although mean scores for both groups indicated participants were, on average, "at risk" for health literacy problems, English speakers had a significantly higher mean total score (3.82, standard deviation [SD] = 1.60) than did Spanish speakers (2.61, SD = 1.71), indicating better literacy. DISCUSSION: Study findings of low levels of health literacy in many parents led to a practice change of using nurse-developed pictographs, along with discharge instructions, for specific common ED diagnoses. Postdischarge calls to parents or patients receiving the pictographs documented positive postdischarge client feedback. The pictograph strategy is transferable to other institutions.

Icons for health effects of cigarette smoke: a test of semiotic type.

We sought to identify icons to effectively communicate health harms of chemicals in cigarette smoke. Participants were a convenience sample of 701 U.S. adults. A within-subjects online experiment explored the effects of icon semiotic type: symbolic (arbitrary, most abstract), indexical, and iconic (representative, most concrete). Outcomes were perceived representation, affect toward smoking, elaboration, perceived severity, and perceived effectiveness. For not-easy-to-visualize harms of cancer and addiction, symbolic icons received the highest ratings (all p < .001). For easy-to-visualize symptoms of heart attack/stroke, indexical icons received the highest ratings (all p < .001). For easy-to-visualize harm of reproductive organ damage, the iconic image did best (all p < .001). Icon type often had a larger impact among participants with higher health literacy. Symbolic icons may be most effective for health effects not easily visualized. Iconic or indexical icons may be more effective for health effects attributable to specific body parts or symptoms.

Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing, Decision Making, and Liking in an Eye-Tracking Study.

Researchers recommend the use of pictographs in medical risk communication to improve people's risk comprehension and decision making. However, it is not yet clear whether the iconicity used in pictographs to convey risk information influences individuals' information processing and comprehension. In an eye-tracking experiment with participants from the general population (N = 188), we examined whether specific types of pictograph icons influence the processing strategy viewers use to extract numerical information. In addition, we examined the effect of iconicity and numeracy on probability estimation, recall, and icon liking. This experiment used a 2 (iconicity: blocks vs. restroom icons) × 2 (scenario: medical vs. nonmedical) between-subject design. Numeracy had a significant effect on information processing strategy, but we found no effect of iconicity or scenario. Results indicated that both icon types enabled high and low numerates to use their default way of processing and extracting the gist of the message from the pictorial risk communication format: high numerates counted icons, whereas low numerates used large-area processing. There was no effect of iconicity in the probability estimation. However, people who saw restroom icons had a higher probability of correctly recalling the exact risk level. Iconicity had no effect on icon liking. Although the effects are small, our findings suggest that person-like restroom icons in pictographs seem to have some advantages for risk communication. Specifically, in nonpersonalized prevention brochures, person-like restroom icons may maintain reader motivation for processing the risk information.

Automated pictographic illustration of discharge instructions with Glyph: impact on patient recall and satisfaction.

OBJECTIVES: First, to evaluate the effect of standard vs pictograph-enhanced discharge instructions on patients' immediate and delayed recall of and satisfaction with their discharge instructions. Second, to evaluate the effect of automated pictograph enhancement on patient satisfaction with their discharge instructions. MATERIALS AND METHODS: Glyph, an automated healthcare informatics system, was used to automatically enhance patient discharge instructions with pictographs. Glyph was developed at the University of Utah by our research team. Patients in a cardiovascular medical unit were randomized to receive pictograph-enhanced or standard discharge instructions. Measures of immediate and delayed recall and satisfaction with discharge instructions were compared between two randomized groups: pictograph (n = 71) and standard (n = 73). RESULTS: Study participants who received pictograph-enhanced discharge instructions recalled 35% more of their instructions at discharge than those who received standard discharge instructions. The ratio of instructions at discharge was: standard = 0.04 ± 0.03 and pictograph-enhanced = 0.06 ± 0.03. The ratio of instructions at 1 week post discharge was: standard = 0.04 ± 0.02 and pictograph-enhanced 0.04 ± 0.02. Additionally, study participants who received pictograph-enhanced discharge instructions were more satisfied with the understandability of their instructions at 1 week post-discharge than those who received standard discharge instructions. DISCUSSION: Pictograph-enhanced discharge instructions have the potential to increase patient understanding of and satisfaction with discharge instructions. CONCLUSION: It is feasible to automatically illustrate discharge instructions and provide them to patients in a timely manner without interfering with clinical work. Illustrations in discharge instructions were found to improve patients' short-term recall of discharge instructions and delayed satisfaction (1-week post hospitalization) with the instructions. Therefore, it is likely that patients' understanding of and interaction with their discharge instructions is improved by the addition of illustrations.

Neural correlates for aesthetic appraisal of pictograph and its referent: An fMRI study.

As one kind of language symbols, pictograph has a graphical structure based on its referential object. Are the aesthetic qualities of these referential objects reflected in the cognitive and neural processing of the font structure of pictographs? In this present study, participants performed aesthetic judgments on both pictographs and their referential object images whilst acquiring fMRI data. Square luminance judgment was served as baseline to control for activity in motor brain regions associated with the key responses. Behavioral results showed both font structures of pictographs and their corresponding object images which refer to beautiful objects were rated significantly higher on beauty than those refer to ugly objects. Functional MRI revealed regions of occipital lobe, frontal lobe and inferior orbitofrontal cortex (OFC) that were commonly activated for pictographs and object images referring to beautiful objects in the direct contrasts between beautiful judgment and luminance judgment. Moreover, only the aesthetic judgments of beauty for the pictographs but not the object images elicited activation of motor areas, which implied relevant embodied experience was elicited during the aesthetic perception of novel pictographs. In contrast, activities associated with pictographs referring to ugly objects were limited to visual processing regions of the bilateral inferior occipital gyri, which could be due to the intentions of avoiding ugly or aversive stimulus. In addition, object images were associated with broader recruitment in cortical areas than pictographs, likely due to the increased visual processing demands for the more visually complex object images. These findings indicate that aesthetic perceptions for the font structures of pictographs were derived from their referential objects, which could arouse a similar sense of beauty supported by common neural mechanisms with other aesthetic objects.

High Numerates Count Icons and Low Numerates Process Large Areas in Pictographs: Results of an Eye-Tracking Study.

In two experiments, we investigated the influence of numeracy on individuals' information processing of pictographs depending on numeracy via an eye-tracker. In two conditions, participants from the general population were presented with a scenario depicting the risk of having cancer and were asked to indicate their perceived risk. The risk level was high (63%) in experiment 1 (N = 70) and low (6%) in experiment 2 (N = 69). In the default condition, participants were free to use their default strategy for information processing. In the guiding-toward-the-number condition, they were prompted to count icons in the pictograph by answering with an explicit number. We used eye-tracking parameters related to the distance between sequential fixations to analyze participants' strategies for processing numerical information. In the default condition, the higher the numeracy was, the shorter the distances traversed in the pictograph were, indicating that participants counted the icons. People lower in numeracy performed increased large-area processing by comparing highlighted and nonhighlighted parts of the pictograph. In the guiding-toward-the-number condition, participants used short distances regardless of their numeracy, supporting the notion that short distances represent counting. Despite the different default processing strategies, participants processed the pictograph with a similar depth and derived similar risk perceptions. The results show that pictographs are beneficial for communicating medical risk. Pictographs make the gist salient by making the part-to-whole relationship visually available, and they facilitate low numerates' non-numeric processing of numerical information. Contemporaneously, pictographs allow high numerates to numerically process and rely on the number depicted in the pictograph.

Assessing Pictograph Recognition: A Comparison of Crowdsourcing and Traditional Survey Approaches.

BACKGROUND: Compared to traditional methods of participant recruitment, online crowdsourcing platforms provide a fast and low-cost alternative. Amazon Mechanical Turk (MTurk) is a large and well-known crowdsourcing service. It has developed into the leading platform for crowdsourcing recruitment. OBJECTIVE: To explore the application of online crowdsourcing for health informatics research, specifically the testing of medical pictographs. METHODS: A set of pictographs created for cardiovascular hospital discharge instructions was tested for recognition. This set of illustrations (n=486) was first tested through an in-person survey in a hospital setting (n=150) and then using online MTurk participants (n=150). We analyzed these survey results to determine their comparability. RESULTS: Both the demographics and the pictograph recognition rates of online participants were different from those of the in-person participants. In the multivariable linear regression model comparing the 2 groups, the MTurk group scored significantly higher than the hospital sample after adjusting for potential demographic characteristics (adjusted mean difference 0.18, 95% CI 0.08-0.28, P<.001). The adjusted mean ratings were 2.95 (95% CI 2.89-3.02) for the in-person hospital sample and 3.14 (95% CI 3.07-3.20) for the online MTurk sample on a 4-point Likert scale (1=totally incorrect, 4=totally correct). CONCLUSIONS: The findings suggest that crowdsourcing is a viable complement to traditional in-person surveys, but it cannot replace them.

Animated randomness, avatars, movement, and personalization in risk graphics.

BACKGROUND: Risk communication involves conveying two inherently difficult concepts about the nature of risk: the underlying random distribution of outcomes and how a population-based proportion applies to an individual. OBJECTIVE: The objective of this study was to test whether 4 design factors in icon arrays-animated random dispersal of risk events, avatars to represent an individual, personalization (operationalized as choosing the avatar's color), and a moving avatar-might help convey randomness and how a given risk applies to an individual, thereby better aligning risk perceptions with risk estimates. METHODS: A diverse sample of 3630 adults with no previous heart disease or stroke completed an online nested factorial experiment in which they entered personal health data into a risk calculator that estimated 10-year risk of cardiovascular disease based on a robust and validated model. We randomly assigned them to view their results in 1 of 10 risk graphics that used different combinations of the 4 design factors. We measured participants' risk perceptions as our primary outcome, as well as behavioral intentions and recall of the risk estimate. We also assessed subjective numeracy, whether or not participants knew anyone who had died of cardiovascular causes, and whether or not they knew their blood pressure and cholesterol as potential moderators. RESULTS: Animated randomness was associated with better alignment between risk estimates and risk perceptions (F1,3576=6.12, P=.01); however, it also led to lower scores on healthy lifestyle intentions (F1,3572=11.1, P<.001). Using an avatar increased risk perceptions overall (F1,3576=4.61, P=.03) and most significantly increased risk perceptions among those who did not know a particular person who had experienced the grave outcomes of cardiovascular disease (F1,3576=5.88, P=.02). Using an avatar also better aligned actual risk estimates with intentions to see a doctor (F1,3556=6.38, P=.01). No design factors had main effects on recall, but animated randomness was associated with better recall for those at lower risk and worse recall for those at higher risk (F1,3544=7.06, P=.01). CONCLUSIONS: Animated randomness may help people better understand the random nature of risk. However, in the context of cardiovascular risk, such understanding may result in lower healthy lifestyle intentions. Therefore, whether or not to display randomness may depend on whether one's goal is to persuade or to inform. Avatars show promise for helping people grasp how population-based statistics map to an individual case.

Functional MRI Study on Perceiving Orthographic Structure and Simplified Semantic Pictures

The different perceiving patterns of each picture, alphabetic words and Chinese characters, were widely investigated psychophysically. The more precise localisation can be done in terms of brain activity using functional image technique such as PET and fMRI recently. Until now, there was no fMRI study to make direct comparison between perception of single Chinese character and simplified pictures (pictograph). We have made direct comparison of these two components using modern magnetic resonance techniques. We cannot confirm the right hemispheric dominance for perception of single Chinese character and pictographs. These two kinds of perceiving pattern can be underlying different mechanism.