Special article
Good morning, Doctor Google
Bom dia, Doutor Google
a Dirección del Plan Director de las Enfermedades del Aparato Respiratorio PDMAR (Departament de Salut), Área de Innovación, Institut d’Estudis de la Salut, (Departament de Salut), Barcelona, Spain
b Indesinenter, Barcelona, Spain
c Área de Innovación, Institut d’Estudis de la Salut, Departament de Salut, Barcelona, Spain
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Escarrabill, T. Martí, E. Torrente" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Escarrabill" "email" => array:1 [ 0 => "jescarrabill@gencat.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "T." "apellidos" => "Martí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Torrente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Dirección del Plan Director de las Enfermedades del Aparato Respiratorio PDMAR (Departament de Salut), Área de Innovación, Institut d’Estudis de la Salut, (Departament de Salut), Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Indesinenter, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Área de Innovación, Institut d’Estudis de la Salut, Departament de Salut, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "de" => array:1 [ "titulo" => "Bom dia, Doutor Google" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Internet: born at the end of the 20<span class="elsevierStyleSup">th</span> century</span><p id="par0005" class="elsevierStylePara elsevierViewall">Thomas S. Kuhn perfectly describes the manner in which scientific knowledge is developed.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Knowledge is not based on accumulation or on effort. It is not entirely reliant on one person or spawned on one specific day. Scientific revolutions occur by a process which involves the intervention of various people, facts and events which, if analyzed in isolation, might appear arbitrary or even insignificant. Attempting to identify the exact date when the paradigm shift occurs is futile.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this attempt to observe the paradigm shift which occurred in relation to the internet, it is necessary to start the discussion by referring back to the workings of the Advanced Research Projects Agency Network (ARPANET) at the beginning of the 1960<span class="elsevierStyleHsp" style=""></span>s, during the darkest days of the Cold War. It was based on the transmission of packets of information (Packet switching) via a closed network of independent nodes, without a central hub, so that the information flowing through the network was less vulnerable to the destruction of one node. In 1989, nearly 30 years after ARPANET, Tim Berners-Lee (1955) developed the World Wide Web, an application which permitted the sharing of files over the internet.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The most important element of Berners-Lee's contribution was that it allowed the free use of this design. But many could argue that this intervention did not necessarily signal the birth of the internet. It is true that without www, the formation of the internet would have been more difficult, but still, we cannot describe Berners-Lee's network in the same terms with which we define the internet today.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In order to understand the internet (the 21<span class="elsevierStyleSup">st</span> century internet) we have to digress and consider the interaction of two relevant developments which, initially, followed a parallel course: digitalization and networking. Connection (networking) is possible without digitalization (the telephone existed before the digital age, for example). But the great power of the internet resides precisely in this combination of digitalization and networking. Digitalization, which is defined as the conversion of information (sound, image or text) into a binary code, is what led to the explosive growth of the net.</p><p id="par0020" class="elsevierStylePara elsevierViewall">But above all, digitalization allows the inversion of roles, especially with regards to who is considered the “producer” and who is the “consumer”. Don Tapscott coined the term “prosumer”<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in order to help resolve this issue.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">From web 1.0 to web 2.0</span><p id="par0025" class="elsevierStylePara elsevierViewall">In this historic journey, some people have remained at the first station: consulting web pages. In the early stages of the net, web pages were “visited” and searches were very limited (exact sentences, grouping of addresses in thematic blocks), very precise and had a significant rigidity in the consultations (you could consult what you could see). The consumer's role in this first stage can be summed up in one word: “browse” and that is what is known as web 1.0. In the last few years the internet has undergone a radical transformation to what is now generically defined as 2.0. Google is the paradigm (allowing the management of information in addition to browsing) and the user is now also the producer of information (in part thanks to digitalization) in a manner in which the traditional division between producer and consumer is more difficult to establish and, finally, through the so-called syndication tools, it is no longer necessary to search for information because it is possible to receive the type of information desired in the format requested.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">From replacement to radical transformation</span><p id="par0030" class="elsevierStylePara elsevierViewall">Genís Roca suggests<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> that this transition from web 1.0 to 2.0 is a process which is systematically repeated as digital tools are diffused the network usage becomes profuse. In the first phase there is replacement; as with the CD replacing the conventional vinyl disc, the changes in format and business model are not significant. However, when we pass on to the mp3 player and the commercialization of music online through specific programs, we are facing a radical transformation. This transformation changes the business model and the way in which we use the technology, rendering all the previous devices obsolete.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Digitalization and networking have been introduced into the health sector but we still find ourselves in the first phase of replacement. Instead of typewriters we have computers, but in many ways we continue to use them like typewriters. We save information (lots of information) but a lot of the time we access it as if it were a metal fling cabinet (the information is stored in files alphabetically or by year). We are at an early stage in the process of digitalization and network usage and, even though it could take a while, the radical transformation will profoundly alter the way in which health care is organized.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">The impact of the internet on clinical practice</span><p id="par0040" class="elsevierStylePara elsevierViewall">Conventional clinical practice is based on face to face contact in a “health care” environment (the hospital ward, the consult, emergency services…) organized in a sequential manner (and very often without the necessary coordination between the different care sectors or between the various departments in one center). These meetings are scattered (without a pre-established plan, more reactive than proactive), short (in terms of duration) and sporadic (in terms of frequency). This type of clinical practice is based on very precise coordinates of time and place. The result is time consuming (especially for the patient) and inevitably leads to coordination difficulties (due to the rigid organization of the appointment as well as the non-compatibility of the computer systems<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>).</p><p id="par0045" class="elsevierStylePara elsevierViewall">The first impact made by the internet on clinical practice is that it radically changes the coordinates of time and place.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The paradigm of the new care model is based more on contacts than on visits.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The place is no longer confined to the health care space. There are alternatives to conventional hospitalization; now the patient's home is identified as an adequate place to receive care, replacing the absolute necessity of admission.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> However, the impact of the internet on clinical practice allows new locations to be proposed which were unthinkable until very recently. In a well-connected society, it is possible to conceive consults in shopping centers<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> or patient follow-ups in day centers in the case of elderly patients who are more or less dependant. But mobile phone technology creates the potential for care spaces which would have been considered pure fantasy until now. The fastest rate of growth in mobile phones is taking place in developing countries.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Mobile phones are used to communicate, to receive messages… but a cough analysis via mobile phone allows a doctor to make a differential diagnosis.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Without entering into too much detail, these examples serve to demonstrate the impact of new technologies. Until recently there was talk of telemedicine as a new paradigm, but the reality has exceeded expectations. Changes in health care location do not presuppose the application of complex methods; on the contrary, they are related to everyday tools such as the mobile phone or the television.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Internet brings us new possibilities in relation to time. Communication in everyday life is simultaneous (an SMS) or asynchronous (an email), ubiquitous (the communication can be established from multiple locations) and distributed (is it possible to communicate from one to many or from many to many). Health care cannot distance itself from this general standard. Thus, the concept of “programmed visits” appears very outdated. In fact, the “programmed” visit is still the most common form of contact between patients and health professionals: the face-to-face appointment. Care organizations should be designed to allow patients access to the most appropriate team when they need it. This does not condone the promotion of systematic disorder. But the attitude needs to change with regards to the orientation of the system. It needs to be centered around the needs of the patients, ensuring access and continuity of care, involving the patient in decision-making, promoting self-care and coordinating the available care resources.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The key is to be more proactive and less reactive. A very significant amount of care demand is predictable, especially when it pertains to the care of patients with chronic diseases. There are two elements that must be enhanced in order to make the system more proactive: the first is to recognize the role of diverse health care and non-health care professionals and the second is to implement the systematic use of new technologies. This new relationship framework includes the transfer of tasks from various professions to nurses who, from a more assimilated perspective, play a very important role. But the professionals in the front line are also extremely important, often the ones that are not health professionals at all (such as, for example, the people who answer the phones). The patients’ general predisposition to new technologies is good and very few reject systems based on electronic appointments or access to their doctor via email.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Some studies even found that patients are more inclined to utilize new technologies that the actual doctors.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The use of the internet in doctor-patient relationships is still not very diffuse in Europe<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and organizational aspects (arranging visits or re-fills) are still better developed than the direct consultations with the doctors to address health problems. However, changes are anticipated in the near future given that patient preferences tend towards the diversity of forms of communication with their doctors, including the use of technologies tied in with the internet.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> The most attractive element for the patient in terms of new technologies is the ability to manage their own time.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The concept of “virtual practice” refers to the combination of tools which facilitate patient communication with their doctor regardless of the geographical location of either party. The meeting point is called the “patient portal<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>”, which allows asynchronous (email) and synchronous (web cam) communication and the remote monitoring of physiological variables.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Google as a Swiss Army knife</span><p id="par0070" class="elsevierStylePara elsevierViewall">One of the most profound changes that the web 2.0 tools generate is what is known as knowledge management. At present Google, in clinical practice, is like a multipurpose tool (like a Swiss Army knife): it is a tool for browsing and consulting, a diagnostic support resource and a working tool. But, above all, Google can provide clues about the changing approach to health care practice.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Google, the internet and PubMed have brought about a revolution in scientific research: now the future can be consulted from the past (after finding an article it is easy to identify all the references made to it since the date of publication). Google (and web 2.0 in general) makes it possible to share and collaborate.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Most biomedical reviews have now been equipped with a multimedia format with automatic feeds (RSS), podcasts or videos.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Google could become a valid tool to support the diagnostic process.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Tang et al<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> analyzed the efficaciousness of Google in the diagnosis of clinical cases in a series which was presented weekly in the New England Journal of Medicine and they observed that the diagnosis was correct in 58% of the analyzed cases where a search engine was used. Google could be a great help in the diagnosis of complex medical problems, especially if they are very rare.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The advantages of Google compared to PubMed have been widely debated<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,22</span></a> but the most eclectic perspectives suggest that Google Scholar and PubMed are complimentary resources.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Perhaps Google Scholar allows a faster initial approximation about a problem, especially from a multidisciplinary standpoint,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> and on the other hand PubMed is perhaps more specific.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Google can be a working tool, especially with regards the storage of clinical data. The implementation of an electronic medical record is being slowly established,<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26–28</span></a> but it develops the concept of a personal clinical history in parallel. In the first place you have the simple digitalization of conventional medical records (the health system is still where the data is deposited but it now recognizes the patient as the owner). Secondly, the patient decides where to store the data (for example, using one of the free tools such as Google health) and who has access to it. This is a significant change. The electronic medical records are what we call an “adaptation”. On the other hand, the personal clinical history is a “radical transformation”.</p><p id="par0095" class="elsevierStylePara elsevierViewall">When the incidence of an illness is elevated (as in the case of the flu virus), Google Flu Trends is formidable and can offer information a lot quicker than conventional methods,<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> even in languages besides English.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> This fact demonstrates that the internet can have unexpected uses.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">The role of the patient</span><p id="par0100" class="elsevierStylePara elsevierViewall">Google is useful for patients to diagnose their own complaints<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> and, in some instances, they use it in a quicker and more effective manner than the doctors, especially in cases of minor illnesses.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Google is also used by the patients for consultation purposes and to generate content. The Economist posed the question whether the basic core of “Health 2.0” will not be mixed in with the contents generated by patients.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> The blogging world is enormous. A simple search on Google blogs for the term “COPD” returns more than 300,000 hits. It is true that Google can present problems. The advantages that Google provides for patients and families to facilitate the diagnosis of minor diseases can be a double-edged sword. In some cases, patients who carry out frequent health-related internet searches can cause themselves anxiety, a side-effect which some people term cyberchondria.<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34,35</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Social networks</span><p id="par0110" class="elsevierStylePara elsevierViewall">Social networks are one of the most spectacular derivatives of the internet. In fact, the social network phenomenon on the internet is without equal. Since the birth of the first recognizable virtual social network in 1997<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> (inaugurated in the same year as Google), its use has grown exponentially.</p><p id="par0115" class="elsevierStylePara elsevierViewall">The data clearly corroborates this: 72% of internet users are active in at least one social network.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> Taking into account the fact that, in only ten years, the number of internet users in the world has increased nearly sixfold, going from 361 million in the year 2000 to 1.967 billion in 2010,<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> that figure is hardly negligible.</p><p id="par0120" class="elsevierStylePara elsevierViewall">There are all types of social networks but the majority of them share common characteristics:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0125" class="elsevierStylePara elsevierViewall">Ubiquity: users can connect when they want and where they want</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0130" class="elsevierStylePara elsevierViewall">Immediacy: the contents are updated automatically</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0135" class="elsevierStylePara elsevierViewall">Privacy: the networks administrators decide on the level of privacy</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0140" class="elsevierStylePara elsevierViewall">Collaboration and interaction between peers</p></li></ul></p><p id="par0145" class="elsevierStylePara elsevierViewall">Inevitably, these social networks are having a great impact on the health sector. We find numerous examples of the use of social networks by patients, professionals and institutions both on the more general sites like Facebook, Twitter or Linkedin and on specialized healthcare social networks.</p><p id="par0150" class="elsevierStylePara elsevierViewall">In this way, patient social networks proliferate, virtual spaces where patients with similar conditions get in contact and share health problems and treatments.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> These allow them the opportunity to share experiences and to search, receive and provide information, advice and even emotional support online. Patientslikeme<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> is the paradigm of these networks. Established in 1998 as an initiative of the brother of a patient with ALS, the idea was to encourage the exchange of experiences and knowledge between patients with ALS and share the data with the scientific community in order to accelerate research into the disease.</p><p id="par0155" class="elsevierStylePara elsevierViewall">On the other hand, health professionals are also becoming increasing inclined to organize themselves around specialized social networks. This allows them to maintain contact with other professionals, consult cases and observations, ask for opinions, debate issues or solicit expert medical advice from the appropriate sources. In the United States, Sermo<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> is the largest online community of doctors, with more than 110,000 doctors registered form 68 specialist fields. Esanum<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> is, among others, the equivalent in Europe.</p><p id="par0160" class="elsevierStylePara elsevierViewall">In conclusion, social networks offer wide-ranging possibilities in the field of health care. The most significant change that the potential of virtualization and web 2.0 introduces is the shift from centralized networks to distributed networks. In the distributed networks there are no central nodes. There nodes which are more connected than others but that situation could change with time.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Changes in the working methods</span><p id="par0165" class="elsevierStylePara elsevierViewall">Despite all the literature dedicated to the impact Google has had on health, perhaps the most important aspect is the change in the way in which problems are tackled. Google's search engine sorts responses based on data not on opinions (being able to define precisely how many times a page has been consulted is very different from saying which ones we think are visited a lot). In addition, Google learns from the information so that the data obtained provokes changes in the nest response. Also, Google is easy to use and results are available immediately.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Using the perspective of the “wisdom of the crowds”,<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> Google's value system is based on who is visiting websites not the source of the information. The most valuable pages are the most visited ones. It is true that the Google thought structure is fragmented (in part owing to the intrinsic characteristics of the hyperlink), and the overload of information does run the risk of jeopardizing the coherence. But, perhaps, as Carr suggests, Google is the first step towards artificial intelligence.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Jeff Jarvis, in a fascinating book called “And Google, how would you do it?”,<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a> gives some clues as to the basic workings of Google: how links work on the network, reducing intermediaries and attention to detail (respect for which is small). The key words for the Google model are: listen, innovation, transparency, speed, little control and accessible and simple information. In short, the Google strategy is based on trust. Google takes notice of the users: basing responses on data (not opinions) and using the information to develop the next response (learning from the information). Google is easy to use and immediate.</p><p id="par0180" class="elsevierStylePara elsevierViewall">Some critics attest, correctly, that “the best is not necessarily the most visited”.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a> That is to say, the criterion of frequency is not a guarantee of wisdom or knowledge. But, despite these limitations, it would be an interesting exercise to try to imagine a health organization that was built on a similar system of attending to patients needs.</p><p id="par0185" class="elsevierStylePara elsevierViewall">As the title of this article suggests, Google's day has just begun (in fact, digitalization and the internet have not yet passed first grade). It is understandable that some people show glimpses of skepticism. But the future is headed in one direction and to avoid being swept along with that would be impossible (and lethal).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interests</span><p id="par0195" class="elsevierStylePara elsevierViewall">Authors declare that they don’t have any conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Internet: born at the end of the 20 century" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "From web 1.0 to web 2.0" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "From replacement to radical transformation" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "The impact of the internet on clinical practice" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Google as a Swiss Army knife" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "The role of the patient" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Social networks" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Changes in the working methods" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-03-18" "fechaAceptado" => "2011-03-24" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:47 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La estructura de las revoluciones científicas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Thomas S. Kuhn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1975" "editorial" => "Fondo de Cultura Económica" "editorialLocalizacion" => "México" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Berners-Lee Tim. Information Management: A Proposal. CERN. March 1989, May 1990. Available from: <a href="http://www.w3.org/History/1989/proposal.rtf">http://www.w3.org/History/1989/proposal.rtf</a>." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Wikinomics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Tapscott" 1 => "D. Williams" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2006" "editorial" => "Atlantic Books" "editorialLocalizacion" => "London" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Congreso de los Diputados. Comisión de Industria, Turismo y Comercio. Comparecencia para informar sobre redes de alta velocidad. 29 de septiembre de 2010. Available from: <a href="http://www.congreso.es/public_oficiales/L9/CONG/DS/CO/CO_607.PDF">http://www.congreso.es/public_oficiales/L9/CONG/DS/CO/CO_607.PDF</a>." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coordinating care-a perilous journey through the health care system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T. Bodenheimer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Engl J Med" "fecha" => "2008" "volumen" => "358" "paginaInicial" => "1064" "paginaFinal" => "1071" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How Web 2.0 is changing medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Giustini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.39062.555405.80" "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2006" "volumen" => "333" "paginaInicial" => "1283" "paginaFinal" => "1284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17185707" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary care needs a new model of office practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.E. Scherger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2005" "volumen" => "330" "paginaInicial" => "358" "paginaFinal" => "359" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Home hospitalisation of exacerbated chronic obstructive pulmonary disease patients" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "CHRONIC project" "etal" => true "autores" => array:6 [ 0 => "C. Hernandez" 1 => "A. Casas" 2 => "J. Escarrabill" 3 => "J. Alonso" 4 => "J. Puig-Junoy" 5 => "E. Farrero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "58" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12570110" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Gómez, Manuel V. Salir de médicos. El País. 28/10/08. Available from: <a href="http://www.elpais.com/articulo/carreras/capital/humano/Salir/medicos/elpepueconeg/20081005elpnegser_7/Tes">http://www.elpais.com/articulo/carreras/capital/humano/Salir/medicos/elpepueconeg/20081005elpnegser_7/Tes</a>." ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Mobile marvels. The economist. 24 de septiembre de 2009. Available from: <a href="http://www.economist.com/node/14483896">http://www.economist.com/node/14483896</a>." ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Chivers T. Cough into your mobile phone for instant diagnosis. The Telegraph. 9/11/09. Available from: <a href="http://www.telegraph.co.uk/health/healthnews/6530704/Cough-into-your-mobile-phone-for-instant-diagnosis.html">http://www.telegraph.co.uk/health/healthnews/6530704/Cough-into-your-mobile-phone-for-instant-diagnosis.html</a>." ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systems approach to patient-centered care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.C. Bergeson" 1 => "J.D. Dean" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.296.23.2848" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2006" "volumen" => "296" "paginaInicial" => "2848" "paginaFinal" => "2851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17179462" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Communication between physicians and patients in the era of E-medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.H. Stone" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMp068198" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2007" "volumen" => "356" "paginaInicial" => "2451" "paginaFinal" => "2454" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17568026" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Crossing the digital divide: evaluating online communication between patients and their providers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.J. Katz" 1 => "N. Nissan" 2 => "C.A. Moyer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Manag Care" "fecha" => "2004" "volumen" => "10" "paginaInicial" => "593" "paginaFinal" => "598" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15515991" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Online communication between doctors and patients in Europe: status and perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "S. Santana" 1 => "B. Lausen" 2 => "M. Bujnowska-Fedak" 3 => "C. Chronaki" 4 => "P.E. Kummervold" 5 => "J. Rasmussen" 6 => "T. Sorensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2196/jmir.1281" "Revista" => array:5 [ "tituloSerie" => "J Med Internet Res" "fecha" => "2010" "volumen" => "12" "paginaInicial" => "e20" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20551011" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Consumers Would Embrace Email Communication With Their Doctor. 29/10/09. Available from: <a href="http://www.lightspeedresearch.com/press-releases/consumers-would-embrace-email-communication-with-their-doctor/">http://www.lightspeedresearch.com/press-releases/consumers-would-embrace-email-communication-with-their-doctor/</a> (last access 10/01/11)." ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Dixon, RF, Perrotti, R. The virtual practice. Tomorrow's medicine, today. Available from: <a href="http://www2.massgeneral.org/beaconhill/The%2520Virtual%2520Practice_9-08.pdf">http://www2.massgeneral.org/beaconhill/The%20Virtual%20Practice_9-08.pdf</a>." ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis using search engines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Gardner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.39044.369745.BE" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2006" "volumen" => "333" "paginaInicial" => "1131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17138971" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Googling for a diagnosis--use of Google as a diagnostic aid: internet based study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Tang" 1 => "J.H. Ng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.39003.640567.AE" "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2006" "volumen" => "333" "paginaInicial" => "1143" "paginaFinal" => "1145" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17098763" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Greenwald R…And a diagnostic test was performed. N Engl J Med 2005;353:2089-2090." ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of PubMed and Google Scholar literature searches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.E. Anders" 1 => "D.P. Evans" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respir Care" "fecha" => "2010 May" "volumen" => "55" "paginaInicial" => "578" "paginaFinal" => "583" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20420728" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "<a href="http://neurodojo.blogspot.com/">http://neurodojo.blogspot.com</a>." ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Literature search on risk factors for sarcoma: PubMed and Google Scholar may be complementary sources" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Mastrangelo" 1 => "E. Fadda" 2 => "C.R. Rossi" 3 => "E. Zamprogno" 4 => "A. Buja" 5 => "L. Cegolon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1756-0500-3-131" "Revista" => array:5 [ "tituloSerie" => "BMC Res Notes" "fecha" => "2010" "volumen" => "3" "paginaInicial" => "131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20459746" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "HealthLinks. University of Washington. Available from: <a href="http://healthlinks.washington.edu/howto/googlechart.html">http://healthlinks.washington.edu/howto/googlechart.html</a>." ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Google Scholar versus PubMed in locating primary literature to answer drug-related questions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.K. Freeman" 1 => "S.A. Lauderdale" 2 => "M.G. Kendrach" 3 => "T.W. Woolley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1L223" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2009" "volumen" => "43" "paginaInicial" => "478" "paginaFinal" => "484" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19261965" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of electronic health records in U.S. hospitals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:9 [ 0 => "A.K. Jha" 1 => "C.M. DesRoches" 2 => "E.G. Campbell" 3 => "K. Donelan" 4 => "S.R. Rao" 5 => "T.G. Ferris" 6 => "A. Shields" 7 => "S. Rosenbaum" 8 => "D. Blumenthal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMsa0900592" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2009" "volumen" => "360" "paginaInicial" => "1628" "paginaFinal" => "1638" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19321858" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acceptability of a personally controlled health record in a community-based setting: implications for policy and design" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.R. Weitzman" 1 => "L. Kaci" 2 => "K.D. Mandl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2196/jmir.1187" "Revista" => array:5 [ "tituloSerie" => "J Med Internet Res" "fecha" => "2009" "volumen" => "11" "paginaInicial" => "e14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19403467" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tectonic shifts in the health information economy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.D. Mandl" 1 => "I.S. Kohane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMsb0800220" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2008" "volumen" => "358" "paginaInicial" => "1732" "paginaFinal" => "1737" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18420506" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Monitoring influenza activity in Europe with Google Flu Trends: comparison with the findings of sentinel physician networks - results for 2009-10" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Valdivia" 1 => "J. Lopez-Alcalde" 2 => "M. Vicente" 3 => "M. Pichiule" 4 => "M. Ruiz" 5 => "M. Ordobas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Euro Surveill" "fecha" => "2010 Jul 22" "volumen" => "15" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Valdivia A, Monge-Corella S. Diseases tracked by using Google trends, Spain [letter]. Emerg Infect Dis [serial on the Internet] 2010 Jan [date cited]. Available from: <a href="http://www.cdc.gov/EID/content/16/1/168.htm">http://www.cdc.gov/EID/content/16/1/168.htm</a>." ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patients using the Internet to obtain health information: how this affects the patient–health professional relationship" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. McMullan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pec.2005.10.006" "Revista" => array:6 [ "tituloSerie" => "Patient Educ Couns" "fecha" => "2006" "volumen" => "63" "paginaInicial" => "24" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16406474" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "‘Doctor Google’ ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.G. Bouwman" 1 => "Q.G.A. Teunissen" 2 => "F.A. Wijburg" 3 => "G.E. Linthorst" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2009.171827" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2010" "volumen" => "95" "paginaInicial" => "642" "paginaFinal" => "644" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20418338" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Health 2.0. The Economist. 6/09/07." ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "White, RW, Horvitz, E. Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search. Microsoft Research. 2008. Available from: <a href="http://research.microsoft.com/apps/pubs/default.aspx%3Fid=76529">http://research.microsoft.com/apps/pubs/default.aspx?id=76529</a>." ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "‘Doctor Google’ ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.G. Bouwman" 1 => "Q.G. Teunissen" 2 => "F.A. Wijburg" 3 => "G.E. Linthorst" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2009.171827" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2010" "volumen" => "95" "paginaInicial" => "642" "paginaFinal" => "644" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20418338" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social network sites: Definition, history, and scholarship" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.M. Boyd" 1 => "N.B. Ellison" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Journal of Computer-Mediated Communication" "fecha" => "2007" "volumen" => "13" "paginaInicial" => "article 11" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Insites Consulting. Available from: <a href="http://blog.insites.be/%3Fp=1704">http://blog.insites.be/?p=1704</a>." ] ] ] 37 => array:3 [ "identificador" => "bib0190" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Royal Pingdom.Available from: <a href="http://royal.pingdom.com/2010/10/22/incredible-growth-of-the-internet-since-2000/">http://royal.pingdom.com/2010/10/22/incredible-growth-of-the-internet-since-2000/</a>." ] ] ] 38 => array:3 [ "identificador" => "bib0195" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Torrente E, Escarrabill J, Martí, T (2010) “Impacto de las redes sociales de pacientes en la práctica asistencial,” Revista de Innovación Sanitaria y Atención Integrada: Vol. 2: Iss. 1, Article 1. Available from: <a href="http://pub.bsalut.net/risai/vol2/iss1/1">http://pub.bsalut.net/risai/vol2/iss1/1</a>." ] ] ] 39 => array:3 [ "identificador" => "bib0200" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Patients Like Me. Available from: <a href="http://www.patientslikeme.com/">http://www.patientslikeme.com</a>." ] ] ] 40 => array:3 [ "identificador" => "bib0205" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Bray, David A., Croxson, Karen, Dutton, William H. and Konsynski, Benn, Sermo: A Community-Based, Knowledge Ecosystem. Oll Distributed Problem-Solving Networks Conference, February 2008; Oll Distributed Problem-Solving Networks Conference, February 2008. Available at SSRN: <a href="http://ssrn.com/abstract=1016483">http://ssrn.com/abstract=1016483</a>." ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Esanum. Available from: <a href="http://www.esanum.es/">http://www.esanum.es/</a>." ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Filés: democracia económica en el siglo de las redes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. De Ugarte" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2009" "editorial" => "Ediciones El Cobre" "editorialLocalizacion" => "Barcelona" ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0220" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cien mejor que uno" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "James Surowiecki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2005" "editorial" => "Ediciones Urano SA" "editorialLocalizacion" => "Barcelona" ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0225" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Shallows. What the Internet is doing to our brains" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Nicholas Carr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2010" "editorial" => "WW Nortin & Company" "editorialLocalizacion" => "New York" ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0230" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Jarvis J. Y Google, ¿cómo lo haría? Barcelona. Gestión 2000 (Grupo Planeta). 2010." ] ] ] 46 => array:3 [ "identificador" => "bib0235" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Googléame" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Cassin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "Fondo de Cultura Económoca" "editorialLocalizacion" => "Buenos Aires" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08732159/0000001700000004/v2_201509041537/S0873215911000341/v2_201509041537/en/main.assets" "Apartado" => array:4 [ "identificador" => "9579" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Artigo especial" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001700000004/v2_201509041537/S0873215911000341/v2_201509041537/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911000341?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 14 | 12 | 26 |
| 2024 October | 53 | 59 | 112 |
| 2024 September | 49 | 47 | 96 |
| 2024 August | 60 | 46 | 106 |
| 2024 July | 104 | 47 | 151 |
| 2024 June | 63 | 38 | 101 |
| 2024 May | 44 | 47 | 91 |
| 2024 April | 45 | 35 | 80 |
| 2024 March | 42 | 32 | 74 |
| 2024 February | 67 | 25 | 92 |
| 2024 January | 40 | 27 | 67 |
| 2023 December | 21 | 40 | 61 |
| 2023 November | 31 | 30 | 61 |
| 2023 October | 31 | 30 | 61 |
| 2023 September | 26 | 33 | 59 |
| 2023 August | 23 | 23 | 46 |
| 2023 July | 19 | 34 | 53 |
| 2023 June | 24 | 12 | 36 |
| 2023 May | 47 | 32 | 79 |
| 2023 April | 40 | 27 | 67 |
| 2023 March | 84 | 16 | 100 |
| 2023 February | 50 | 16 | 66 |
| 2023 January | 29 | 20 | 49 |
| 2022 December | 49 | 19 | 68 |
| 2022 November | 71 | 32 | 103 |
| 2022 October | 28 | 33 | 61 |
| 2022 September | 24 | 33 | 57 |
| 2022 August | 37 | 39 | 76 |
| 2022 July | 43 | 42 | 85 |
| 2022 June | 31 | 38 | 69 |
| 2022 May | 45 | 40 | 85 |
| 2022 April | 38 | 33 | 71 |
| 2022 March | 32 | 37 | 69 |
| 2022 February | 33 | 33 | 66 |
| 2022 January | 38 | 33 | 71 |
| 2021 December | 48 | 45 | 93 |
| 2021 November | 41 | 31 | 72 |
| 2021 October | 55 | 34 | 89 |
| 2021 September | 58 | 34 | 92 |
| 2021 August | 27 | 20 | 47 |
| 2021 July | 34 | 25 | 59 |
| 2021 June | 31 | 22 | 53 |
| 2021 May | 71 | 21 | 92 |
| 2021 April | 45 | 47 | 92 |
| 2021 March | 45 | 11 | 56 |
| 2021 February | 34 | 10 | 44 |
| 2021 January | 26 | 12 | 38 |
| 2020 December | 34 | 14 | 48 |
| 2020 November | 44 | 23 | 67 |
| 2020 October | 35 | 14 | 49 |
| 2020 September | 45 | 36 | 81 |
| 2020 August | 51 | 24 | 75 |
| 2020 July | 54 | 27 | 81 |
| 2020 June | 69 | 19 | 88 |
| 2020 May | 64 | 23 | 87 |
| 2020 April | 55 | 16 | 71 |
| 2020 March | 47 | 16 | 63 |
| 2020 February | 83 | 16 | 99 |
| 2020 January | 57 | 19 | 76 |
| 2019 December | 56 | 16 | 72 |
| 2019 November | 44 | 17 | 61 |
| 2019 October | 53 | 17 | 70 |
| 2019 September | 58 | 14 | 72 |
| 2019 August | 196 | 18 | 214 |
| 2019 July | 224 | 9 | 233 |
| 2019 June | 225 | 9 | 234 |
| 2019 May | 182 | 14 | 196 |
| 2019 April | 207 | 20 | 227 |
| 2019 March | 241 | 11 | 252 |
| 2019 February | 220 | 12 | 232 |
| 2019 January | 243 | 21 | 264 |
| 2018 December | 181 | 9 | 190 |
| 2018 November | 63 | 0 | 63 |
| 2018 October | 63 | 6 | 69 |
| 2018 September | 48 | 4 | 52 |
| 2018 August | 94 | 26 | 120 |
| 2018 July | 98 | 16 | 114 |
| 2018 June | 51 | 20 | 71 |
| 2018 May | 58 | 16 | 74 |
| 2018 April | 77 | 18 | 95 |
| 2018 March | 88 | 26 | 114 |
| 2018 February | 41 | 9 | 50 |
| 2018 January | 49 | 13 | 62 |
| 2017 December | 41 | 28 | 69 |
| 2017 November | 43 | 8 | 51 |
| 2017 October | 28 | 14 | 42 |
| 2017 September | 37 | 22 | 59 |
| 2017 August | 64 | 16 | 80 |
| 2017 July | 47 | 10 | 57 |
| 2017 June | 51 | 19 | 70 |
| 2017 May | 51 | 13 | 64 |
| 2017 April | 26 | 4 | 30 |
| 2017 March | 46 | 12 | 58 |
| 2017 February | 22 | 10 | 32 |
| 2017 January | 35 | 10 | 45 |
| 2016 December | 39 | 11 | 50 |
| 2016 November | 31 | 4 | 35 |
| 2016 October | 22 | 6 | 28 |
| 2016 September | 10 | 4 | 14 |
| 2016 August | 8 | 5 | 13 |
| 2016 July | 6 | 4 | 10 |
| 2016 May | 10 | 0 | 10 |
| 2016 April | 38 | 2 | 40 |
| 2016 March | 48 | 11 | 59 |
| 2016 February | 71 | 13 | 84 |
| 2016 January | 37 | 9 | 46 |
| 2015 December | 48 | 8 | 56 |
| 2015 November | 25 | 6 | 31 |
| 2015 October | 34 | 8 | 42 |
| 2015 September | 35 | 12 | 47 |
| 2015 August | 61 | 7 | 68 |
| 2015 July | 31 | 6 | 37 |
| 2015 June | 31 | 6 | 37 |
| 2015 May | 104 | 5 | 109 |
| 2015 April | 116 | 8 | 124 |
| 2015 March | 79 | 5 | 84 |
| 2015 February | 102 | 6 | 108 |
| 2015 January | 98 | 11 | 109 |
| 2014 December | 144 | 17 | 161 |
| 2014 November | 100 | 8 | 108 |
| 2014 October | 114 | 13 | 127 |
| 2014 September | 96 | 11 | 107 |
| 2014 August | 102 | 19 | 121 |
| 2014 July | 122 | 8 | 130 |
| 2014 June | 118 | 3 | 121 |
| 2014 May | 89 | 9 | 98 |
| 2014 April | 90 | 10 | 100 |
| 2014 March | 94 | 15 | 109 |
| 2014 February | 85 | 10 | 95 |
| 2014 January | 92 | 14 | 106 |
| 2013 December | 89 | 5 | 94 |
| 2013 November | 76 | 15 | 91 |
| 2013 October | 80 | 10 | 90 |
| 2013 September | 80 | 13 | 93 |
| 2013 August | 130 | 15 | 145 |
| 2013 July | 126 | 14 | 140 |
| 2013 June | 134 | 13 | 147 |
| 2013 May | 126 | 12 | 138 |
| 2013 April | 123 | 21 | 144 |
| 2013 March | 87 | 10 | 97 |
| 2013 February | 95 | 21 | 116 |
| 2013 January | 90 | 17 | 107 |
| 2012 December | 100 | 16 | 116 |
| 2012 November | 48 | 18 | 66 |
| 2012 October | 21 | 8 | 29 |
| 2012 September | 13 | 8 | 21 |
| 2012 January | 426 | 0 | 426 |
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