Ryan Black

The words “cancer” and “emoji” don’t often command the same seriousness. A new study out of Mayo Clinic, however, poses the idea that emojis may help doctors better study and understand how cancer patients are feeling about their disease and treatment.“Emojis are a near universal, popular form of communication, understandable by diverse populations, including those with low health literacy,” Carrie Thompson, MD, said in a statement. Thompson is a researcher in the Division of Hematology at Mayo, and she’s lead author on the study By collecting patient-reported outcomes (PROs) via emojis inputted into mobile devices, the Mayo team thought that they could potentially relieve some of the traditional challenges of reporting outcomes, which they called “burdensome,” while also studying associations between PROs and data gathered from health wearables.“If we can demonstrate that simple emojis are a valid and reliable measure of patient well-being, it could transform the way patient well-being assessments are accomplished,” Thompson said.To test the idea, her team recruited 115 patients diagnosed with lymphoma and multiple myeloma in the previous 5 years, all expected to live more than 6 months. The study was built on Apple’s ResearchKit platform, so patients had to have an iPhone. They were supplied with an Apple Watch, and they downloaded the corresponding study app at the beginning of the research.The Apple Watch collected health vitals, like physical activity, sleep, heart rate, and fatigue. The researchers developed a pair of emoji scales to measure mood and physical, emotional, and overall quality of life (QOL). The app allowed patients to input data with both emojis and traditional methods like the Patient-Reported Outcomes Measurement Information System (PROMIS).The researchers found a significant correlation emoji responses and standard linear analog self-assessment PROs for fatigue, physical well-being, emotional well-being, and overall quality of life. Data collected by Apple Watch also showed correlations between activity and mood: Higher steps per day had a strong association with patient outcomes.“There are several studies that attempt to predict individual well-being 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,” Thompson said . “In the future, it may be possible to monitor patient symptoms and communicate with patients between appointments via wearable technology.”Patients also overwhelmingly preferred reporting their outcomes with smart phones and watches for PROs over the alternatives: 100% reported they would recommend use of the technology, compared to 87% who recommended an iPad, only 20% who recommended collection by paper survey or live telephone interview, and 0% who endorsed automated telephone interviews.The work is ongoing, and Thompson said future studies will be needed to validate the use of wearables and emojis in ongoing cancer care. A poster from the study was presented this week at the American Society of Hematology’s 59Annual Meeting in Atlanta, Georgia.