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Cognitive informatics in health and biomedicine : understanding and modeling health behaviors
Patel V., Arocha J., Ancker J., Springer International Publishing, New York, NY, 2017. 383 pp. Type: Book (978-3-319517-31-5)
Date Reviewed: Apr 9 2018

Health-related decisions are often based on personal experiences, biases, trust, knowledge (or lack of it), and the physical and social environment (availability, friends and family, and so on). This book fills an important gap by discussing health informatics concepts from a cognitive science perspective and summarizing research demonstrating how such concepts can be used to develop more effective patient-centric interventions.

The book is loosely structured into six parts containing 17 chapters, which vary between summaries of the authors’ own research and broad reviews of particular research topics. One positive consequence of this is that the book presents a lot of state-of-the-art research and includes many recent references. On the negative side, the flow between chapters is sometimes weak, there is a lack of cross references, and some parts are slightly repetitive. For example, behavioral models (largely the same ones) are presented in chapters 2, 10, and 15.

Most chapters provide valuable insights, but some of them would benefit from more synthesized information, such as guidelines, drawbacks, and limitations, which would aid researchers and application developers in creating successful interventions. For example, chapter 2 gives an excellent overview of behavioral informatics intervention and the underlying behavioral change theory models, but provides few results. This is remedied by other chapters in the book presenting case studies of such applications. I would have liked to see a whole chapter focusing on the design, application, and evaluation aspects (some issues are covered in Section 2.2.4). Similarly chapters 3 and 5 provide a fascinating picture of how folk cognition and health beliefs influence patients’ behavior, but provide little information to what extent and how these insights can be translated to other indigenous groups. A section summarizing related work and identifying commonalities and differences would have been useful.

Some of the strongest chapters combine reviews of the state of the art, with case studies and discussion of implications of the results. For example, the real-world examples in Section 6.6 were insightful, and I found the listed characteristics of successful health education/information applications (page 134) very valuable. Chapter 7 provides an excellent overview of techniques for and the challenge of measuring cognitive function. The argument for a more model-based approach is convincing and nicely exemplified by Section 7.3.1. Chapter 15 was fascinating, although I found some of the sections (for example, on automated models for text analysis) hard to understand for a reader without a machine learning background. The discussion in Section 15.5.5 demonstrates the opportunities of the described approach. Chapter 16 gives an excellent overview of game-based behavioral change and provides a great summary of design considerations for game-based interventions. Several case studies are included, although it was not clear to me how they incorporated the previously mentioned design guidelines. For example, is the game illustrated in Figure 16.6 really “fun to play”? Maybe a link to a website or YouTube video of the game would help.

Health literacy and numeracy are important topics and are discussed in detail in chapters 6, 9, 11, and 13. I enjoyed particularly the latter two chapters. Chapter 11 provides many useful summaries (for example, the summary of assessment tests in Box 11.1) and examples (for example, how the dosing instruction “give 2 pills every 12 hours” can be misunderstood by many patients and reformulated to improve understanding). Chapter 13 provides an excellent overview of e-health applications and the implications of health literacy, and it also contains useful design guidelines in its conclusion section.

I would have liked to see more discussions about visual information (images, videos, virtual reality (VR), games, and so on) for health informatics. The use of images is mentioned in one paragraph on page 287 and the topic of games and VR is discussed in chapter 16. The topic deserves a more extensive discussion considering that some of the most successful public health campaigns (for example, to combat smoking and drunk driving) are based on images and videos.

Overall, I really enjoyed reading the book and I believe it is a valuable resource for researchers, application developers, practitioners, and decision makers in health informatics and public health.

Reviewer:  Burkhard Wuensche Review #: CR145959 (1806-0300)
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