Although icons are presented as a universal language, some claim that cultural background, education and environment might influence the users' interpretation of their meaning. If this is true, the iconic language should be adapted to the user's characteristics. This paper presents results of a study that was aimed at designing the iconic language of a medical decision support system to be used in several European countries. The study included four main phases: listing and classification of the messages to be represented, collection of proposals about icons from representatives of potential users, preparation of candidates for evaluation and final evaluation of candidates by a sample of users. Results of this study indicate which icons are universally considered as "good" or "bad", and which ones are "controversial", that is, which are clearly preferred or clearly rejected by different interviewed subgroups. These results are also compared with results of previous studies, to single out factors which seem to condition acceptance of iconic messages. Finally, the paper describes the architecture of the interface which supports adapting icons to the user characteristics.
(C) 1995 Academic Press Limited