Emoticons are increasingly being used in medical records, especially in the US. A report from the University of Michigan Medical School identified the 50 most frequently used emoticons in 4,162 electronic health record files from 372 different emoticons. A quarter of them were used repeatedly in the same sets of notes, for a total of 7,130 instances. Each emoticon was used between 18 and 1,772 times, with a median of 36 and an interquartile range of 24-85. The most commonly used was "smiling face with smiling eyes". A dozen of the 50 most used were variations of this smiley, totaling 2,284 occurrences.