Emojis have emerged as a universal means of expressing emotions in the current socio-cultural landscape; yet, their application in patient-reported outcomes (PROs) remains underexplored. Previous research has demonstrated that emoticons can effectively and intuitively convey emotional states across different cultures and languages. For instance, studies have shown that emojis can enhance the accuracy of self-reported mood and well-being by providing a more relatable and accessible mode of expression compared to traditional text-based surveys. In the context of incurable diseases such as Multiple Sclerosis (MS), communicating emotional states to care teams is crucial for optimal disease management and improved PROs. This study involved 200 MS patients who assessed their cognitive status, mood, fatigue, and ambulation using the Mayo Clinic Electronic Emoji-Based Neurological Impairment Status (MEBNIS) survey. Each participant also completed multiple well-established clinical tests/surveys for MS evaluation and underwent 3T brain MRIs within one year of the clinical evaluations. To validate the MEBNIS survey, we compared its results with those from the other clinical tests/surveys. Our findings revealed several strong positive correlations between MEBNIS results and other clinical test outcomes. In addition, MRI analysis showed negative correlations between the emoji-based responses and respective brain region volumes. Furthermore, patient engagement improved with the use of MEBNIS. These results demonstrate that MEBNIS provides an effective and user-friendly method for assessing neurological impairment in MS patients, offering an overview of their status while bridging language barriers and literacy gaps, thus facilitating more natural communication between patients and healthcare providers.
