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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">This musculoskeletal disease is very common in the general population&#44; generating 20&#37; of primary care consultations&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> The epidemiological study by the Spanish Society of Rheumatology at the end of the 90s showed that over 20&#37; of people over 20 presented with some type of rheumatologic disease&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> Consultations in this area in private medicine is divided between trauma&#44; rehabilitation and rheumatology specialties&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Private rheumatology is a speciality area which has boomed in recent years&#44; 38&#46;2&#37; of Spanish rheumatologists practise the specialty in the private sector&#44; the majority of them in mixed form &#40;25&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> The autonomous communities with the greatest number of rheumatologists who practise privately are Catalonia and Madrid&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> The private sector is highly relevant&#44; since approximately a third of the national health budget was dedicated to private medicine in 2013<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> and specifically over 700 million euros in the autonomous community of Madrid &#40;CAM&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We are currently aware of the state of private rheumatology in Spain related to professionals and distribution by autonomous communities&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> but no information exists regarding the type of patient and the diseases they deal with&#46; The CAM has 150 rheumatologists on public hospital staffs 33&#46;8&#37; of whom also work in the private sector&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> No precise details exist regarding the number of rheumatologists who exclusively practise in the private sector today&#44; but the Spanish Society of Rheumatology is currently making attempts to rectify this&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In general&#44; it is accepted that the diseases attended in rheumatology in the private sector and in the public sector are similar&#44; where over 25&#37; of care is dedicated to inflammatory disease&#44; whilst osteoarthritis and osteoporosis make up a slightly lower percentage &#40;21&#37;&#41;&#44; but certain differences may exist&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Lamentably&#44; there is little available information relating to private practice&#46; Knowledge regarding patient type and disease diagnosed&#44; together with resources consumed&#44; is important for better management and quality in private rheumatology practice&#44; being beneficial both for the national health system&#44; for the rheumatologists and above all for the patient&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this descriptive study of private outpatient rheumatology practise is to provide information on the disease and the general traits of the patients cared for&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Patients</span><p id="par0030" class="elsevierStylePara elsevierViewall">An observational descriptive study of patients who were consecutively seen in 2 private rheumatology medical centres for 3 years&#46; This included patients who were attended in the Hospital Ruber Internacional and in the Armstrong Clinic&#44; both in Madrid&#46; In both centres&#44; outpatient care was undertaken in external consultancy once a week&#44; with the possibility of hospital admittance&#46; Consultations from emergencies and day hospital only took place in the Hospital Ruber Internacional&#46; Ultrasound scans were not available in either of the 2 centres&#44; which depended on X-ray services for imaging technique&#44; whilst the capillaroscopy was available only in the Hospital Ruber Internacional&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Demographic data was collected &#40;age&#44; gender&#44; date of first consultation and diagnosis&#41; and descriptive data from the private practice &#40;insurance company or private company&#44; total number of appointments&#44; new consultations vs check-up&#44; number of consultations not presented&#44; tests requested and interconsultations to other specialists&#41;&#46; The patients freely requested consultation&#46; New consultations were considered to be all those patients who were attended for the first time and check-ups were all subsequent consultations&#46; A non attended consultation was that where an appointment was requested and the patient did not present&#44; but did not previously cancel the appointment&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The initial diagnostic impression or the final diagnosis&#44; whenever possible&#44; were collected and were summarised as chronic arthritis &#40;rheumatoid arthritis&#44; spondyloartritis&#44; psoriatic arthritis&#44; idiopathic juvenile arthritis&#44; connective tissue diseases &#40;lupus&#44; inflammatory myopathies&#44; Sj&#246;gren&#39;s syndrome and scleroderma&#41;&#44; osteopenia&#47;osteoporosis&#44; osteoarthritis &#40;regardless of location&#41;&#44; non specific arthromyalgias&#44; soft tissue rheumatisms &#40;e&#46;g&#46; epichondylitis&#44; trochanteritis&#44; mechanical plantar fasciitis&#44; etc&#46;&#41;&#44; microcrystalline arthritis &#40;gouty arthritis and calcium pyrophosphate dehydrate arthritis&#41;&#44; non-specific axial pain &#40;non inflammatory lumbago&#44; back pain and cervical pain&#41;&#44; analytical alterations &#40;positive antibodies&#44; increase in acute phase reactants or muscle enzymes&#44; raised anti-strepomycin antibodies&#44; etc&#46;&#41;&#44; fibromyalgia&#44; rheumatic polymyalgia and &#8220;others&#8221;&#46; Included in &#8220;others&#8221; are those diseases which make up under 1&#37; of the total patients attended &#40;e&#46;g&#46; episcleritis&#44; idiopathic hyperostosis&#44; Raynaud&#39;s phenomenon&#44; Paget&#39;s disease&#44; etc&#46;&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Further tests were requested&#44; blood sample and imaging tests &#40;plain X-rays&#44; musculoskeletal ultrasound &#40;MSU&#41;&#44; densitometries&#44; magnetic resonances &#91;MR&#93; and computerised tomographies&#41;&#44; together with interconsultations with other specialities&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The results are presented in total numbers and percentages &#40;&#37;&#41; for the qualitative variables and in medians and range for the qualitative variables&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">706 patients were attended in 207 days of consultation&#44; with a mean of 7&#46;2 patients seen per day&#46; A total of 1493 medical visits were programmed&#44; there were 706 &#40;47&#46;3&#37;&#41; new consultations and 612 &#40;41&#37;&#41; check-ups&#44; whilst consultations which patients did not attend were 175 &#40;11&#46;7&#37;&#41;&#46; Median age was 44&#46;3 years &#40;range 3&#8211;93&#41; and 511 patients were women &#40;72&#46;4&#37;&#41;&#46; The majority of patients&#44; 83&#46;1&#37; &#40;587 patients&#41;&#44; were clients of the companies MAPFRE&#44; Adeslas and Asisa&#46; The complete list of patients&#44; and which insurance companies they belonged to is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The most common diagnoses were osteoarthritis &#40;148 patients&#44; 20&#46;9&#37;&#41;&#44; osteopenia&#47;osteoporosis &#40;119 patients&#44; 16&#46;8&#37;&#41;&#44; non specific arthromyalgias &#40;95 patients&#44; 13&#46;4&#37;&#41; and the soft tissue rheumatisms &#40;68 patients&#44; 9&#46;6&#37;&#41;&#46; The first three diagnoses made up for 51&#37; of patients and together with rheumatisms of soft tissues they covered 61&#37; of total diagnoses&#46; The complete list of diagnoses is presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A total of 659 analytic tests were requested &#40;0&#46;5 per visit&#41; and 558 imaging tests &#40;0&#46;42 per visit&#41;&#46; Of the imaging tests&#44; plain X-ray was the most frequent&#44; 61&#46;8&#37; &#40;345 X-rays&#41;&#44; MSU was 20&#46;1&#37; &#40;112&#41;&#44; MR 9&#46;1&#37; &#40;51&#41; and densitometries 8&#46;6&#37; &#40;48&#41;&#59; only 2 tomographies were requested&#46; 120 interconsultations were requested from other specialities&#44; 99 &#40;82&#46;5&#37;&#41; from the rehabilitation service&#46; The other interconsultations were divided into 7 &#40;5&#46;8&#37;&#41; from traumatology&#44; 6 &#40;5&#37;&#41; from the pain unit&#44; 2 &#40;1&#46;6&#37;&#41; from the digestive and endocrinology unit and one interconsultation &#40;0&#46;8&#37;&#41; from dermatology&#44; immunology&#44; ophthalmology and pneumology&#46; The total list of complementary tests and interconsultations is contained in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Out of the total patients 325 &#40;46&#37;&#41; were attended just once&#46; Of the 381 patients who went at least once for a check-up&#44; mean time of follow-up was 1&#46;3 years &#40;range 0 to 3 years&#41;&#46; In that initial consultation 155 analytical tests were requested&#44; 173 imaging tests and 32 interconsultations &#40;30 from rehabilitation&#41;&#46; As a consequence&#44; the result of 23&#46;5&#37; of the analyses and 27&#46;6&#37; of the imaging tests requested during the initial consultation were not reviewed in a second consultation&#46; Imaging tests made up for 20&#46;8&#37; of densitometries &#40;10&#47;48&#41;&#44; 29&#46;4&#37; of MR &#40;15&#47;51&#41;&#44; 21&#46;4&#37; of MSU &#40;24&#47;112&#41; and 30&#46;1&#37; of plain X-rays &#40;104&#47;345&#41;&#46; Demographic characteristics and the percentage of different diagnoses in this subgroup of patients was super-imposable with the total patients&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">During the 3 years of private rheumatology practice&#44; mostly middle aged women who had an insurance policy were seen&#46; They presented with osteoarthritis&#44; osteoporosis&#44; non specific arthromyalgias or soft tissue rheumatisms&#46; The situation of rheumatology in public medicine has been studied on a national level and autonomous community level<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">4&#44;6&#8211;8</span></a> and also recently in private healthcare&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> but there is still very little information relating to the high percentage of patients who are seen by private rheumatology departments&#46; In our study&#44; care of osteoarthritis and osteoporosis account for 38&#37; of the work load&#44; whilst chronic arthritis accounts for 7&#44;8&#37; and connective tissue diseases for 1&#46;9&#37;&#46; The study by L&#225;zaro et al&#46;&#44; undertaken in the CAM in 2013&#44; described that in public rheumatology services chronic arthritis accounted for almost 30&#37; of the work load and connective tissue diseases for 9&#46;4&#37;&#59; but osteoarthritis and osteoporosis accounted for 21&#37; of it&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> There are therefore differences in the diseases attended by private rheumatology departments &#40;more osteoarthritis and osteoporosis&#41; and public ones &#40;more chronic arthritis and connective tissue diseases&#41;&#46; Notwithstanding&#44; further studies are needed to confirm these differences&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In our study&#44; approximately one out of every 10 patients who requested consultation in private rheumatology departments did not attend their consultation&#44; and had no scientific literature with which to compare these results with the public medical sector&#46; Of particular interest was the fact that almost half of the patients &#40;46&#37;&#41; with appointments in the private sector were only seen once and that one out of every 4 tests requested&#44; or analytical test and imaging tests were not reviewed in a second consultation&#46; It is not possible to know whether they were reviewed by other specialities or were not undertaken&#44; but maybe the initial consultation resolved the doubts for many patients about whether the pain they presented with was due to a serious illness and they did not complete the additional tests requested&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In contrast to the general concept of private medicine&#44; the number of patients seen privately is a low percentage &#40;3&#37;&#41;&#44; with the majority of patients &#40;&#62;80&#37;&#41; being clients of the main insurance companies &#40;MAPFRE&#44; Adeslas and Asisa&#41;&#46; Our results may not of course be extrapolated totally to CAM&#44; due to the number of patients seen and also that despite the great majority being available&#44; some of the existing insurers were not available in any of the 2 centres where the study was carried out&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The additional tests most requested were analyses and imaging tests &#40;X-rays&#44; MSU and MR&#41;&#44; one for each 2 consultations&#44; and the most interconsulted specialty was rehabilitation &#40;&#62;82&#37; of interconsultations&#41;&#46; The availability of an ultrasound in private rheumatology consultation facilitates diagnosis and the resolution of many soft tissue processes seen&#44; reducing the number of check-ups and interconsultations to rehabilitation&#44; as well as reducing the number of imaging studies&#44; and in particular those of extra MSU and MR studies&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The main limitation of this study is its limited external validity with information on 2 private rheumatology centres of the CAM being provided&#44; and with the need for further studies &#40;with the inclusion of care quality or severity of patients seen&#41; and multicentres to confirm these findings&#46; Furthermore&#44; the general descriptive nature of the study and the coding of the diagnoses&#44; without making use of code CIE-9 could be a limiting study factor&#46; However&#44; for the most part the diseases seen are highly prevalent and well differentiated from one another&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">To conclude&#44; private outpatient rheumatology in the CAM mainly treats middle-aged women with an insurance policy who present with osteoarthritis&#44; osteoporosis&#44; non-specific arthromyalgias or soft tissue rheumatisms&#46; However&#44; a quarter of the imaging studies and analyses requested were not undertaken or reviewed by the specialist who requested them&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflict of Interests</span><p id="par0105" class="elsevierStylePara elsevierViewall">The author confirms that there are no conflicts of interest in this document&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The status of private rheumatology is known&#44; but there is no information on the kind of patients seen&#46; This study describes the experience over a 3-year period in a private rheumatology practice in the Autonomous Community of Madrid&#46; We collected demographic and descriptive data&#46; Of 706 patients seen&#44; almost half &#40;46&#37;&#41; were there for their first visit&#44; and 12&#37; of patients who had asked for an appointment did not attend&#46; The majority of patients were women &#40;72&#46;4&#37;&#41; with a median age of 44&#46;3 years old &#40;range 3&#8211;93&#41;&#46; The most frequent diagnoses were osteoarthritis &#40;20&#46;9&#37;&#41;&#44; osteopenia&#47;osteoporosis &#40;16&#46;8&#37;&#41;&#44; arthralgia &#40;13&#46;4&#37;&#41; and soft tissue disorder &#40;9&#46;6&#37;&#41;&#46; The majority of the patients had private insurance with Spanish companies&#44; such as MAPFRE&#44; Adeslas and Asisa&#46; At least one quarter of ancillary tests ordered in the first visit were not revised on a second visit&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se conoce el estado de la reumatolog&#237;a privada en Espa&#241;a&#44; pero no hay informaci&#243;n sobre el tipo de pacientes atendidos&#46; Este estudio describe la experiencia de varios a&#241;os de pr&#225;ctica de reumatolog&#237;a privada a tiempo parcial en la comunidad aut&#243;noma de Madrid&#46; Se recogieron los datos demogr&#225;ficos y descriptivos de consulta de pacientes atendidos de forma consecutiva durante 3 a&#241;os&#46; De un total de 706 pacientes atendidos&#44; casi la mitad &#40;46&#37;&#41; solo acudi&#243; una vez a consulta y el 12&#37; de los pacientes que se citaron no llegaron a presentarse a la cita&#46; La mayor parte de los pacientes fueron mujeres &#40;72&#44;4&#37;&#41; con una edad media de 44&#44;3 a&#241;os &#40;rango 3-93&#41;&#46; Los diagn&#243;sticos m&#225;s frecuentes fueron artrosis &#40;20&#44;9&#37;&#41;&#44; osteopenia&#47;osteoporosis &#40;16&#44;8&#37;&#41;&#44; artromialgias inespec&#237;ficas &#40;13&#44;4&#37;&#41; y reumatismos de partes blandas &#40;9&#44;6&#37;&#41;&#46; La mayor&#237;a de los pacientes&#44; un 83&#44;1&#37; &#40;587 pacientes&#41;&#44; eran clientes de las compa&#241;&#237;as MAPFRE&#44; Adeslas y Asisa&#46; Aproximadamente una cuarta parte de las pruebas complementarias que se piden en consulta no se revisan en consultas posteriores&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Nieto Gonz&#225;lez JC&#46; Reumatolog&#237;a privada ambulatoria&#44; estudio descriptivo en la Comunidad de Madrid&#46; Reumatol Clin&#46; 2019&#59;15&#58;e10&#8211;e13&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">List of patients seen in the private outpatients department&#44; according to the insurance company&#46;</p>"
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                  <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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of patients&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentages&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic inflammatory arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Connective tissue diseases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Microcrystalline arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oseoarthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;1&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Osteopenia&#47;osteoporosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non specific arthromyalgias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non specific axial pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Analytical alterations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Soft tissue rheumatism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibromyalgia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#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="\n
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                  \t\t\t\t">Rheumatic polymyalgia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#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="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Others&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;9&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-with-role" title="\n
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                  \t\t\t\t">48 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">51 &#40;9&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Computerised tomography &#40;<span class="elsevierStyleItalic">n</span>&#58; 558&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">120 &#40;17&#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="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">ICP traumatology &#40;<span class="elsevierStyleItalic">n</span>&#58; 120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;5&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">ICP Pain unit &#40;<span class="elsevierStyleItalic">n</span>&#58; 120&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">ICP other specialties &#40;<span class="elsevierStyleItalic">n</span>&#58; 120&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8 &#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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          "identificador" => "bibs0015"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gesti&#243;n cl&#237;nica y calidad en reumatolog&#237;a"
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                      "titulo" => "Estado de la reumatolog&#237;a privada en Espa&#241;a"
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                            0 => "B&#46; Yoldi Mu&#241;oz"
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                    0 => array:2 [
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              "identificador" => "bib0060"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Los reumat&#243;logos en la asistencia p&#250;blica espa&#241;ola"
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                        0 => array:2 [
                          "etal" => false
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                    0 => array:1 [
                      "Revista" => array:5 [
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                0 => array:2 [
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                      "titulo" => "La Reumatolog&#237;a en la comunidad de Madrid&#58; disponibilidad actual de reumat&#243;logos y necesidades futuras aplicando un modelo predictivo"
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                            3 => "S&#46; Casta&#241;eda"
                            4 => "J&#46; L&#243;pez Robledillo"
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                      "doi" => "10.1016/j.reuma.2013.01.005"
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                  "referenciaCompleta" => "Prevalencia e impacto de las enfermedades reum&#225;ticas en la poblaci&#243;n adulta espa&#241;ola&#46; EPISER&#44; 2000&#46; Madrid&#58; Sociedad Espa&#241;ola de Reumatolog&#237;a&#59; 2001&#46;"
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                      "titulo" => "Situaci&#243;n laboral de los reumat&#243;logos formados en Espa&#241;a entre 1990 y 1999"
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                          "etal" => false
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                            2 => "E&#46; Mart&#237;n Mola"
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                      "titulo" => "Asistencia reumatol&#243;gica en el sector sanitario p&#250;blico de Catalu&#241;a&#58; a&#241;o 2012"
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                        0 => array:2 [
                          "etal" => false
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