Emojis may mostly be used as playful add-ons to text messages, but they could be key to helping providers track patients' overall wellbeing. 

Researchers at the Mayo Clinic found that using emojis instead of the traditional emotional scales helped asses patients’ physical emotional and overall quality of life. The abstract, which was presented at the American Society of Hematology, also found that patients preferred using iPhones and Apple Watches to track outcomes and activity, and that technology was key in collecting study data accurately. 

“Patient-reported outcomes (PROs) are extremely important to understand the patient experience, either when managing an individual patient in practice or when studying the effect of new therapies in a clinical trial,” Dr. Carrie Thompson, lead author of the study and a hematologist at the Mayo Clinic, wrote in an email to MobiHealthNews. “Emojis offer a method for surveying patients that is simple, quick, and can be used regardless of language and health literacy.  Although our study was limited to cancer patients, emoji scales could be used in other patient populations. This will require further study to ensure that the scale is valid, but our results are very encouraging.”

One hundred and fifteen patients with lymphoma or multiple myeloma and a life expectancy of less than five years participated in the ongoing study. All of the participants had an iPhone 5 or later and were given an Apple Watch. Participants then downloaded the study as an app. 

Patients were asked to rate their fatigue, physical wellbeing, emotional wellbeing, and overall wellbeing on a scale of 1 to 10. Participants were also asked to respond to the same questions using the emoji scales. While only 15 participants have completed the study thus far, all 115 participants' data was recorded in the abstract. 

Researchers found that emoji responses were significantly associated with patient recorded outcomes. 

"Emojis are a near-universal, popular form of communication, understandable by diverse populations, including those with low health literacy,” Thompson said in a statement. "There are several studies that attempt to predict individual wellbeing based on analysis of social media postings on Facebook and Twitter, but these studies do not focus on emojis as a mechanism for patients to express how they are feeling on a given day. If we can demonstrate that simple emojis are a valid and reliable measure of patient wellbeing, it could transform the way patient wellbeing assessments are accomplished."

The study’s authors also looked for correlations between the other health data tracked by the Apple Watches and PROs. Researchers found a strong correlation in PROs between steps per day and patients reports of physical wellbeing. 

The authors concluded that using wearable technology and smart phones is feasible and preferred by patients. They also wrote in the study that further studies are needed to analyze the ability of activity data and predict longitudinal changes in PROs. 

Now researcher have expanded the enrollment to 300 participants. Full results of the study will be submitted to the American Society of Hematology's 2018 meetings.

“Further studies are needed to determine the impact of collecting PROs and physical activity data in cancer patients, particularly the impact on improving symptoms, quality of life, and survival,” Thompson wrote. 
 
Emojis have been used in clinical settings before, with one hospital in Sydney, Australia having introduced a patient emoji communication board for children and adolescence.