Imagery and Insight: A Qualitative Visual Analysis of Paediatric Cancer Patients’ Drawings on Clinical Research Using the DRAWEP Framework
DOI:
https://doi.org/10.37506/f4vbba64Keywords:
AI in Art Analysis, Paediatric Oncology, DRAWEP Framework, Clinical trials, Patient AdvocacyAbstract
Background: Paediatric assent and engagement in clinical research pose ethical and developmental challenges, particularly when research concepts are communicated primarily through verbal explanations. Visual methods such as drawing offer an alternative pathway to capture children’s thinking and to better understand their unspoken perspectives.
Objective: To explore how paediatric cancer patients conceptualize clinical research and clinical trials through hand-drawn posters, using the Drawing-Based Emotional Processing (DRAWEP) framework supported by AI-assisted qualitative analysis.
Methods: This qualitative exploratory study involved secondary analysis of hand-drawn posters created by children during an International Clinical Trials Day (ICTD 2025) awareness activity conducted by a national pediatric oncology non-governmental organization. Posters were anonymized, digitized, and analyzed using the Drawing-Based Emotional Processing (DRAWEP) framework. AI-assisted tools were used to support structured thematic organization, with all interpretations reviewed and validated by human researchers.
The DRAWEP framework guided interpretation across the following domains: Description (what is drawn), Reflect (feelings or ideas evoked by the artwork), Analyze (insights into the child’s understanding of research), Wonder (questions arising from the artwork), Evaluate (effectiveness of communication), and Present (summary insight).
Results: Six thematic domains emerged, reflecting emotional, relational, and symbolic representations of clinical research. Common themes included hope, trust, process awareness, and compassion. Several posters also revealed misconceptions, particularly the equating of research with a guaranteed cure (therapeutic misconception) and the conflation of clinician and researcher roles.
Conclusion: Visual expression through drawing provides a developmentally appropriate window into children’s ethical and emotional perceptions of clinical research. Identifying both understanding and misconceptions through such methods may help inform the development of age-appropriate communication strategies in paediatric research settings.
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Copyright (c) 2026 Rhea Aggarwal, Adarsh Keshari, Khushboo Sharma, Saisha Sehrawat, Haresh Gupta, Abir Aggarwal, Padam Singh, Pooja Sharma
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