# A Technological Framework to Support Asthma Patient Adherence Using Pictograms
## 3 Results
### SIMAP Algorithm Results  
In the context of the SIMAP application, we conducted an evaluation of 18 pictograms. Out of these, 11 pictograms related to inhalation techniques were excluded due to their specific indications. Among the remaining selection, we identified seven pictograms that correlated with both usage frequency and dosage information. Upon analyzing the provided indication data, a discernible pattern emerged, linking certain character combinations to their corresponding pictograms. The algorithm is proficient in mapping these character combinations and correctly associating them with the respective pictograms. Moreover, it exhibits the ability to comprehend natural language and establish accurate pictogram associations. It is important to note that the proposed solution operates within the constraints of the input data domain and the predefined output pictograms. Consequently, it cannot establish associations with pictograms beyond those that have been officially approved. With this curated list of pictograms, SIMAP becomes capable of linking medical indications to visual representations, as illustrated in Table 20. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Pictogram** & **Initial Version** & **Modification Requested** & & & \\ \hline
3 & & & & & Remove ’2 puffs under 60 s’ and include the word ’wait’ beneath the stopwatch. & & \\ \hline
12 & & & & Use a solid line, not a dotted line, and emphasize that the nose and mouth are covered. Provide two options, one correct and one incorrect. Display only the profile to highlight the adjustment to the nose and mouth. & & \\ \hline
13 & & & & Shade the area of the mouth covered by the aerocamera. & & \\ \hline
14 & & & & Shade the area of the mouth covered by the aerocamera. & & \\ \hline
15 & & & & Remove “X” from the mouth and show closed lips. & & \\ \hline
16 & & & & Shade the area of the mouth covered by the aerocamera. & & \\ \hline \hline \end{tabular}
\end{table} 
Table 18: Pictograms subject to redesign. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Pictogram** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\begin{tabular}{} \end{tabular}** & **\
\begin{tabular}{} \end{tabular}** & **
\begin{tabular}{} \end{tabular}** \\ \hline
3 & 87.5 & 16 & 14 & 1 & 1 & 0.94 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\
12 & 87.5 & 16 & 14 & 0 & 2 & 0.87 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\
13 & 81.25 & 16 & 13 & 2 & 0 & 1 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\
14 & 93.75 & 16 & 15 & 1 & 0 & 1 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\
15 & 87.5 & 8 & 7 & 0 & 1 & 0.87 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\
16 & 87.5 & 16 & 14 & 2 & 0 & 1 & \
\begin{tabular}{} \end{tabular} &
\begin{tabular}{} \end{tabular} \\ \hline \hline \end{tabular}
\end{table} 
Table 19: Second evaluation of pictogram comprehension by external expert judgement. We conducted three comprehensive evaluations to ascertain the effectiveness of SIMAP in accurately associating medical indications with pictograms that faithfully convey their intended meanings. For the first evaluation, we used a dataset meticulously collected by researchers and personnel from the SIMAP project at the Universidad de Concepcion and the Universidad de Valparaiso. This dataset consisted of a total of 242 medical instructions. Impressively, SIMAP successfully mapped 234 of these instructions to their respective sets of pictograms, achieving a commendable 96.69% accuracy rate in translation.