Designing and reporting pictogram research: Problems, pitfalls and lessons learnt

Research describing the design, evaluation or use of pictograms for various health-related applications is receiving increasing attention in the literature. However, recent reviews of this body of literature have commented adversely on the overall quality of the research, highlighting problems with the pictogram design process, as well as calling for improvement in both the methodology and reporting of all aspects of designing, developing, modifying, evaluating and applying pictograms in practice. The heterogeneity in study design, as well as in the interventions and outcomes measured, prevents overall conclusions being drawn about the effectiveness of pictograms on comprehension and medicine-taking behaviour such as adherence and self-care. The reporting of such research should provide adequate detail to enable reproducibility and replicability of the research. This article offers guidance in designing and reporting pictogram-based research, highlighting areas that are often problematic or inadequately addressed.