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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Rheumatoid arthritis &#40;RA&#41; is a disease that can be prolonged for decades and has a multidimensional impact&#44; ranging from joint destruction to the development of comorbidities and high direct and indirect costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Formal education of RA patients is of the utmost importance&#44; from the perspective of determinants of health<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> or as a predictor of the outcome&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> Information is the platform for acquiring knowledge that will be transformed into behavior that will have an influence on the form with which a person faces disease&#44; makes choices concerning caring for his or her health and adheres to treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A physician provides the scientific information that a patient may need by means of a process of filtering and dosing&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> At the present time&#44; what a patient requires of the physician is greater attention&#44; an improvement in communication&#44; sufficient time during visits and not to have to wait too much to be attended to&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> However&#44; these requirements are frequently not met&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a> Although physicians continue to be the primary source of information&#44; the Internet has become an important option for patients in recent years&#44; at least in countries like the United States of America &#40;US&#41;&#46; For example&#44; 81&#37; of the adults in the US utilize the Internet and 72&#37; mentioned that they had looked for health information over the past 12 months&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> In fact&#44; users of the Internet also visit websites that are specific for health professionals&#59; of the millions of searches carried out each year in the web page of the National Library of Medicine&#44; 33&#37; are performed by the general public&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There are more than 40 publications concerning the quality of the information available on the web related to different diseases and at least 15 on RA&#59; all are in English and analyze websites in English&#46; The conclusions in most of these publications focus on whether the information on the Internet can increment the autonomy of patients&#44; but it can also increase their anxiety and be the source of misleading information due to the heterogeneity and low quality of the information<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;14</span></a>&#59; moreover&#44; patients can become the victims of persons with commercial interests&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; to the best of our knowledge&#44; there are no publications analyzing the characteristics of the information available in the web about RA in Spanish&#46; This is important if we take into account the fact that Spanish is the second language in numbers of first-language speakers in the world<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> and that the utilization of the Internet in Spanish has also increased&#59; it is used by 88&#46;3&#37; of Spaniards<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> and by 50&#46;2&#37; of Mexicans&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> which add up to approximately 103&#46;8 million users&#46; If we consider it true that the prevalence of RA is between 0&#46;5&#37; and 1&#37; of the general population&#44; then there would be between 518 thousand and 1 million RA patients as potential users of the Internet only in those 2 countries&#46; This&#44; and because of the chronicity of RA&#44; it can be assumed that there is a large number of potential users of the Internet who speak Spanish as their first language and search for information on their disease&#46; In the present study&#44; we analyzed the quality of the contents&#44; the legibility and the relevance of the websites with information on RA in Spanish&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a cross-sectional study to audit web pages in the Internet to assess the characteristics of the information related to RA in Spanish&#46; We used the methods of a previous publication from Canada because the detailed description of their methodology enabled us to reproduce it&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> Briefly&#44; we did an extensive search in Spanish&#44; without filters or restrictions&#44; using the phrase &#8220;artritis reumatoide&#8221; via the Google search engine&#44; as it is the engine most widely used in the world&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> The search was conducted on a single day and the resulting web pages were stored in Portable Document Format &#40;PDF&#41; for later assessment&#46; All of the pages were evaluated after being visited and the information had been collected from their associated sites&#46; The web pages from the first 30 pages of results were identified and accessed &#40;hits&#41; &#40;10 hits per results page&#41;&#46; Two sixth-year medical students evaluated each web page separately&#59; discrepancies and&#47;or controversies were resolved by consensus&#44; together with 2 of the participating rheumatologists &#40;DCO and CRR&#41;&#46; We considered a website to be a collection of several related web pages that had a common Internet domain&#46; The evaluation of the pages was performed in accordance with the following domains&#58; relevance&#44; type of publication&#44; scope&#44; contents&#44; authorship and financial objectives&#44; in terms of the definitions provided<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a>&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Relevance&#46; Web pages were considered relevant if the content included some clinical aspect of RA&#8212;etiology&#44; symptoms&#44; signs&#44; diagnosis&#44; treatment and&#47;or prognosis&#46; If the information did not deal with a clinical aspect but could influence the conduct of the patient with respect to the disease&#44; it was considered of doubtful relevance&#46; Only the relevant or those of doubtful relevance continued in the process of evaluation&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">Type of publication&#46; The web pages were classified as advertisements&#44; information&#44; links&#44; new articles&#44; part of a publication&#44; attempts to recruit patients for an investigation&#44; chat rooms&#44; case reports and support group posts&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Scope&#46; We established whether the web pages dealt only with aspects of RA or discussed other autoimmune diseases&#44; and used &#8220;arthritis&#8221; as a general term or in reference to several diseases &#40;fibromyalgia&#44; juvenile idiopathic arthritis&#44; scleroderma&#44; etc&#46;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Contents&#46; The web pages were categorized according to their contents&#58; the inclusion of general information &#40;clinical or epidemiological data on RA&#41; or the mention of conventional therapy or some type of alternative therapy&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">e&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Authorship&#46; The information from the websites was classified as being from a lucrative industry or a for-profit organization&#44; a nonprofit organization&#44; individuals with no clear affiliation and medical institutions &#40;universities&#44; hospitals&#44; medical associations&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">f&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Financial objectives&#46; The websites were cataloged depending on whether they contained explicit information on products being marketed&#44; requested donations or required the payment of a membership fee to accede&#46; They were classified as being direct or indirect product marketing&#44; as requiring a membership fee&#44; as requesting donations or none of the above&#46;</p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall">Aside from the procedures described in the reference study&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> others were added to assess the &#8220;content quality&#8221; domains of the web pages&#44; the legibility and possible variations in the results depending on the Internet Protocol &#40;IP&#41; address utilized&#46; The content quality was evaluated using the DISCERN tool&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> DISCERN is an instrument designed to rate the quality of the content of a publication on the Internet&#44; but cannot be utilized to evaluate the scientific quality or accuracy of the evidence on which the publication is based&#46; DISCERN consists of 15 specific questions plus a question that measures the general quality&#46; Each of the first 15 questions represents in itself a specific quality criterion&#59; the rating is 1 &#40;if the response is &#8220;no&#8221;&#41;&#44; 2&#8211;4 &#40;up to a certain point&#41; or 5 &#40;if the response is a definite &#8220;yes&#8221;&#41;&#46; As our study did not evaluate information on specific treatments and each of the 15 questions represents a separate quality criterion&#44; questions referring to treatments were excluded and we utilized only the following items&#58; 1 &#40;The objectives are clear&#63;&#41;&#59; 2 &#40;Those objectives are achieved&#63;&#41;&#59; 4 &#40;Is there a clear declaration of any sources of information used to compile the data&#44; aside from the author or the product&#63;&#41;&#59; 6 &#40;Is it objective and not biased&#63;&#41;&#59; and 7 &#40;Is data provided on additional sources of support and information&#63;&#41;&#59; question 16 was also included &#40;an intuitive summary of the responses to the 15 previous questions&#47;a subjective evaluation of the general quality&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Legibility was evaluated using the INFLESZ program&#44; which measures the syntactic complexity of a written text&#44; whether it be a complete file or a fragment of a work&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> The score obtained with the INFLESZ scale ranges from 0 to 100&#46; A text is considered to be very difficult to read if the score is from 0 to 40 &#40;scientific or university publications&#41;&#44; somewhat difficult to read with a score of 40&#46;1 to 55 &#40;high school level&#44; specialized journals&#44; etc&#46;&#41;&#59; normal if the score is from 55&#46;1 to 65 &#40;newspapers or sports news&#41;&#44; quite easy with a score is 65&#46;1 to 80 &#40;grade school level&#41; and very easy if the score is over 80&#46;1 &#40;grade school level&#44; comic books&#44; novels&#44; etc&#46;&#41;&#46; For the analysis of legibility&#44; we excluded figures&#44; tables&#44; footnotes&#44; links and other pages and references&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">We analyzed web pages published by hospitals&#44; institutions and societies or medical associations &#40;medical institutions&#41; separately&#44; using the procedures described above&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">To evaluate the possible variation in the results depending on the IP address&#44; we did the same search utilizing 3 different IP addresses&#58; from Guadalajara&#44; Mexico &#40;189&#46;169&#46;108&#46;15&#41;&#44; from San Andr&#233;s&#44; Colombia &#40;104&#46;224&#46;35&#46;115&#41; and from Madrid&#44; Spain &#40;185&#46;25&#46;87&#46;186&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical Analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dichotomized variables were expressed as proportions&#46; Chi-squared test was used to compare the general characteristics&#44; quality and legibility of the web pages in each group according to the order in which they appeared&#44; taking the pages from medical associations&#44; societies and institutions together with the rest of the relevant pages&#46; A <span class="elsevierStyleItalic">P</span> value &#60;&#46;05 was considered to indicate statistical significance&#46; The analysis was done with the STATA &#40;version 12&#46;0&#41; software package&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">We found 323 web pages&#44; 121 &#40;38&#37;&#41; of which were not evaluated &#40;10 because they were in another language and 111 because we considered them irrelevant&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the type of publication&#44; the characteristics of the disease being dealt with and the content of the 202 relevant web pages&#46; In all&#44; 80&#37; of the pages provided general information exclusively on RA&#59; 13&#37; of the pages included an alternative therapy&#44; either as the main topic or in association with conventional therapy&#46; We identified 186 websites&#44; nearly all of which had been created by nonprofit institutions&#44; although only 15&#37; had been posted by a medical institution &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">The evaluation of the content quality showed that 61&#37; of the web pages clearly declared their objectives&#44; but only 48&#37; fulfilled them&#46; Around a third of the pages clearly provided the sources of the information utilized&#44; only 22&#37; offered unbiased information and more than half failed to name additional sources of information&#46; The general quality of a fourth of the pages was considered to be high &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; With respect to the legibility&#44; more than half of the pages were very difficult &#40;9&#37;&#41; or somewhat difficult &#40;52&#37;&#41; to read&#44; whereas a fourth of the pages had a normal level of legibility in accordance with the INFLESZ SCALE &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows the position of the web pages in Spanish belonging to medical institutions&#44; according to the place in which they appeared&#44; the content quality &#40;DISCERN&#41; and legibility &#40;INFLESZ&#41;&#46; Among the first 300 pages that appeared in Google&#44; only 26 &#40;8&#46;6&#37;&#41; were created by medical institutions&#58; 17 &#40;65&#37;&#41; from the US&#44; 7 &#40;27&#37;&#41; from Spain&#44; one from Mexico and one from Venezuela&#46; Among the first 10 websites&#44; 3 were from medical institutions&#59; they included the Arthritis Foundation &#40;US&#41; in 4th place&#44; the Spanish Society of Rheumatology in 8th and 9th positions&#44; and the American College of Rheumatology in 10th place&#46; The web page of the Mexican College of Rheumatology appeared in 118th place&#44; but was classified as irrelevant&#44; and was excluded from the analysis&#46; The only Mexican page included in the analysis was in 31st and 122nd place&#46; The content quality was rated good in 11 pages &#40;42&#37;&#41; and poor in 10 &#40;38&#37;&#41;&#46; Concerning the evaluation of legibility&#44; 8 &#40;31&#37;&#41; were quite easy or easy to read&#44; 9 &#40;35&#37;&#41; were normal and 9 &#40;35&#37;&#41; were somewhat difficult or very difficult to read&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The use of different IP addresses changed the information retrieved only in the web pages labeled by Google as &#8220;advertisements&#8221;&#46; The pages retrieved were the same&#44; although the order in which they appeared changed slightly when different IP addresses were utilized &#40;data not shown&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The importance of this cross-sectional study designed to audit web pages is based on 4 premises&#58; a&#41; there is an upward trend in the utilization of the Internet as a source of health information&#59; b&#41; the information obtained via Internet can influence decision making<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a>&#59; c&#41; there has not been an earlier study similar to this one&#59; and d&#41; the high number of potential users &#40;between 500 thousand and a million RA patients only in Spain and Mexico&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The relevance &#40;specificity&#41; of the web pages obtained via Google is low &#40;62&#37;&#41;&#44; and is similar using different search engines and in other languages&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#44;26</span></a> The majority of the relevant pages are websites providing information specifically on RA&#46; Regarding treatment&#44; nearly half of the relevant pages refer to conventional therapy&#44; and 13&#37; to alternative therapies&#46; Although half of the web pages are posted by nonprofit organizations&#44; only 15&#37; were created by universities&#44; hospitals&#44; associations or medical societies&#46; These results could vary&#44; however&#44; if another search word or strategies and filters were used&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The content quality of the web pages is irregular&#59; the majority express their objectives&#44; but less than half of them fulfill them&#44; and they do not state the source of the information &#40;references&#41;&#59; the quality is rated good in only 1 page in every 4&#46; However&#44; we should bear in mind that DISCERN evaluates the quality of a publication in terms of its content&#44; but not the scientific quality or accuracy of the evidence on which the message it provides is based&#46; On the other hand&#44; there are 2 features that could result in a better or a poorer rating of the relevant pages&#46; The first is the exclusion of several of the DISCERN questions related to the specific evaluation of treatment&#59; the second is the fact that the quality was evaluated by sixth-year medical students&#46; In this respect&#44; we consider that the view of medical students may be &#8220;closer&#8221; to that of the patients than that of rheumatologists&#44; whose evaluation could be contaminated with assessment bias &#40;scientific validity&#41;&#46; Therefore&#44; the rates reported here should be considered subjective and taken from the perspective of the evaluators&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Legibility is a key aspect in preparing any document for patients&#59; it is the whole of the typographical and linguistic characteristics of the written text that make it easy to read and understand&#46; Our results show that the majority of the texts are directed at persons who have attended school for over 12 years&#59; more than half are very difficult or somewhat difficult to read&#46; Difficulties in terms of legibility have also been reported for web-based texts in Spanish concerning other nonrheumatic diseases&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27&#44;28</span></a> In agreement with our results and with the average formal education in Mexico &#40;11&#46;9 years&#41;&#44; more than half of the pages on RA will not be understandable to an average Mexican&#46; The same phenomenon occurs in English&#46; Thus&#44; it has been recommended that the texts have a legibility equivalent to that obtained in 6 years of schooling&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;29</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">It is commendable that universities&#44; hospitals&#44; societies and medical associations &#40;medical institutions&#41; have a predominant position in the large volume of information on RA on the Internet&#46; The position of these institutions can be evaluated&#44; at least partly&#44; considering the potential users&#44; the place they occupy in the pages that appear with the search engine&#44; the content quality and legibility of the text&#46; The number of potential users &#40;RA patients&#41; is high&#46; On the other hand&#44; the place in which a website appears during the search for information is related to user traffic&#46; In a recent study&#44; the percentage of traffic received at the first position in Google was measured in the US and Canada&#59; the website in the first position contributed 33&#37; of the traffic&#44; compared with 18&#37; for the second position&#46; The cumulative loss in traffic when the sites that appear on the first page in Google are compared with those of the second is even more notable&#59; the sites listed in the first 10 results in Google generated 92&#37; of all of the traffic in an average search&#44; and when we changed to the second page in Google&#44; the traffic fell by 95&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> In our study&#44; we found 26 medical institutions that posted their web page in Spanish &#40;within the first 300&#41;&#58; 17 &#40;65&#37;&#41; from the US&#44; 7 &#40;27&#37;&#41; from Spain&#44; one from Venezuela and one from Mexico&#46; The Arthritis Foundation was in 4th place&#44; with good content and a legibility that was &#8220;quite easy to read&#8221;&#59; the Spanish Society of Rheumatology occupied places 8 and 9 &#40;repeated&#41;&#44; with good content in its first appearance and &#8220;normal&#8221; legibility&#59; and the American College of Rheumatology was in 10th place&#44; with good content and &#8220;quite easy&#8221; to read&#46; It is notable that the only Mexican web page which occupied the 31st and 122nd places &#40;repeated&#41;&#44; with good content and &#8220;normal&#8221; legibility&#44; has no rheumatologists among its medical staff&#46; These results correspond to a certain point of time and the position in Google can vary slightly&#44; depending on the IP address&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> However&#44; it is striking that medical institutions in which Spanish is not the official language are in a better position with respect to Spanish-speaking users than the medical institutions of countries in which the predominant mother tongue is Spanish&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In short&#44; RA patients can find a vast amount of information on their disease&#44; although it is irregular in terms of relevance&#44; content quality and legibility&#46; The medical institutions&#44; in general&#44; are also scattered with respect to their position&#59; nevertheless&#44; 3 are within the first 10 positions&#44; although 2 are from the US&#46; There is an area of opportunity so that medical institutions in countries in which Spanish is primarily the mother tongue can take the lead to provide useful information&#44; with quality&#44; that is easy to read and in harmony with the sociocultural characteristics of their patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical Disclosures</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Protection of human and animal subjects</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Confidentiality of data</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Right to privacy and informed consent</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors received no external funding for performing this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of Interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest&#46;</p></span></span>"
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    "fechaAceptado" => "2016-04-22"
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      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec831470"
          "palabras" => array:4 [
            0 => "Rheumatoid arthritis"
            1 => "Internet"
            2 => "Web"
            3 => "Education"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec831471"
          "palabras" => array:4 [
            0 => "Artritis reumatoide"
            1 => "Internet"
            2 => "Web"
            3 => "Educaci&#243;n"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Education is a major health determinant and one of the main independent outcome predictors in rheumatoid arthritis &#40;RA&#41;&#46; The use of the Internet by patients has grown exponentially in the last decade&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To assess the characteristics&#44; legibility and quality of the information available in Spanish in the Internet regarding to rheumatoid arthritis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The search was performed in Google using the phrase rheumatoid arthritis&#46; Information from the first 30 pages was evaluated according to a pre-established format &#40;relevance&#44; scope&#44; authorship&#44; type of publication and financial objective&#41;&#46; The quality and legibility of the pages were assessed using two validated tools&#44; DISCERN and INFLESZ respectively&#46; Data extraction was performed by senior medical students and evaluation was achieved by consensus&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The Google search returned 323 hits but only 63&#37; were considered relevant&#59; 80&#37; of them were information sites &#40;71&#37; discussed exclusively RA&#44; 44&#37; conventional treatment and 12&#37; alternative therapies&#41; and 12&#46;5&#37; had a primary financial interest&#46; 60&#37; of the sites were created by nonprofit organizations and 15&#37; by medical associations&#46; Web sites posted by medical institutions from the United States of America were better positioned in Spanish &#40;Arthritis Foundation 4th position and American College of Rheumatology 10th position&#41; than web sites posted by Spanish speaking countries&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">There is a risk of disinformation for patients with RA that use the Internet&#46; We identified a window of opportunity for rheumatology medical institutions from Spanish-speaking countries to have a more prominent societal involvement in the education of their patients with RA&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Material and methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La educaci&#243;n es un determinante mayor de salud y uno de los predictores independientes de desenlace en artritis reumatoide &#40;AR&#41;&#46; El uso del Internet por pacientes ha crecido en forma exponencial en la &#250;ltima d&#233;cada&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar las caracter&#237;sticas&#44; legibilidad y calidad de la informaci&#243;n disponible en Internet en idioma espa&#241;ol en relaci&#243;n con la AR&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se busc&#243; la frase AR en Google&#46; Se evaluaron las primeras 30 p&#225;ginas de resultados de acuerdo con un formato dise&#241;ado ex profeso &#40;relevancia&#44; autor&#237;a&#44; tipo de publicaci&#243;n&#44; enfermedad discutida e inter&#233;s financiero&#41;&#59; adem&#225;s se evaluaron la calidad y la legibilidad de las p&#225;ginas&#44; con las herramientas DISCERN e INFLESZ&#44; respectivamente&#46; La extracci&#243;n de datos se realiz&#243; por m&#233;dicos pasantes y la evaluaci&#243;n fue por consenso&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron 323 resultados&#44; pero solo el 63&#37; de ellos fueron relevantes&#59; el 80&#37; de estos fueron sitios de informaci&#243;n &#40;71&#37; discut&#237;an exclusivamente AR&#44; 44&#37; terapia convencional y 12&#37; terapias alternativas&#41;&#46; Un 12&#44;5&#37; ten&#237;a inter&#233;s financiero&#46; El 60&#37; de los sitios fueron creados por organizaciones no lucrativas y 15&#37; por asociaciones m&#233;dicas&#46; Las asociaciones m&#233;dicas de Estados Unidos de Am&#233;rica se posicionan mejor en espa&#241;ol &#40;Arthritis Foundation en la posici&#243;n 4 y el American College of Rheumatology en la 10&#41; que los sitios web de pa&#237;ses de habla hispana&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Existe riesgo de desinformaci&#243;n para los pacientes con AR que utilizan la Web&#46; Se identifica adem&#225;s &#225;reas de oportunidad para instituciones m&#233;dicas de pa&#237;ses de habla hispana para tener un mayor involucramiento social en la educaci&#243;n de sus pacientes&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:1 [
            "identificador" => "abst0030"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Material y m&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Castillo-Ortiz JD&#44; Valdivia-Nuno JJ&#44; Ramirez-Gomez A&#44; Garagarza-Mariscal H&#44; Gallegos-Rios C&#44; Flores-Hernandez G&#44; et al&#46; Legibilidad&#44; relevancia y calidad de la informaci&#243;n en espa&#241;ol en la Web para pacientes con artritis reumatoide&#46; Reumatol Clin&#46; 2017&#59;13&#58;139&#8211;144&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Type of publication</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Advertisements&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Information&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Links&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">N</span>ews articles&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Research results&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recruitment of patients for investigation&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;&#60;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chat rooms&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Case reports&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Support group posts&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Disease dealt with</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rheumatoid arthritis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">147 &#40;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthritis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Autoimmune diseases&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Several &#40;arthritic diseases and others&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Content</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>General information&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Conventional therapy&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alternative therapy&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unclear&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Features of the Relevant Web Pages&#46;</p>"
        ]
      ]
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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            "identificador" => "at2"
            "detalle" => "Table "
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        "tabla" => array:1 [
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                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Authorship</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>186&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>For-profit organization&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nonprofit organization&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Individuals with no clear affiliation&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medical associations&#44; universities and hospitals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Financial objective</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>186&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Direct product marketing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Indirect product marketing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Membership required&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;&#60;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Donations requested&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unclear&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None of the above&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Quality as defined by the question&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Partially<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Yes<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&#46; The objectives are clear&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&#46; Is there a clear declaration of any sources of information used for the publication&#44; aside from the author&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&#46; The information is clear and unbiased&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&#46; Is data provided on additional sources of support and information&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">General quality of the publication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Moderate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16&#46; Based on all of the responses&#44; what is the general quality of the publication as a source of information concerning the choice of treatment&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">INFLESZ scale&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">0&#8211;40&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">65&#46;1&#8211;80&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#62;80&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">MEX&#44; Mexico&#59; NIH&#44; National Institutes of Health&#59; SP&#44; Spain&#59; US&#44; United States of America&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Web page&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Position in Google search&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DISCERN<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">INFLESZ<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arthritis Foundation &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Spanish Society of Rheumatology &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44; 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44; 35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">American College of Rheumatology &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cl&#237;nica DAM &#40;private medical specialties in Madrid&#41; &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Centers of Disease Control and Prevention &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medical Center for Rheumatic Diseases &#8211; ARTRICENTER &#40;MEX&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#44; 122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cleveland Clinic &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">University of Chicago Kids Hospital &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">American Academy of Orthopaedic Surgeons &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cl&#237;nica Universidad de Navarra &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">University of California San Francisco Medical Center &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Universidad de las Islas Baleares &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mayo Clinic &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">111&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">New York Presbyterian Hospital &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medical Center for Rehabilitation Premium-Madrid &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">175&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">180&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">218&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Children&#39;s Healthcare of Atlanta &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yale Medical Group &#40;US&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">265&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospital General Universitario de Elda Virgen de la Salud &#40;SP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">279&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;5&nbsp;\t\t\t\t\t\t\n
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