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A apresenta&#231;&#227;o indiscriminada de informa&#231;&#227;o pode culminar na &#8220;desinforma&#231;&#227;o&#8221;&#44; com eventuais repercuss&#245;es negativas na perce&#231;&#227;o da doen&#231;a pela popula&#231;&#227;o<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a>&#46; Este trabalho tem como objetivo descrever a relev&#226;ncia e qualidade da informa&#231;&#227;o cl&#237;nica e cient&#237;fica sobre EAM dispon&#237;vel no <span class="elsevierStyleItalic">site</span> YouTube&#44; em l&#237;ngua portuguesa&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Pesquisa de v&#237;deos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Foram realizadas pesquisas na p&#225;gina do YouTube com um computador ligado &#224; Internet em territ&#243;rio portugu&#234;s&#44; entre 7 de maio e 5 de agosto de 2019&#44; sem <span class="elsevierStyleItalic">login</span> pr&#233;vio e com os <span class="elsevierStyleItalic">cookies</span> eliminados&#46; A combina&#231;&#227;o de termos utilizados para a pesquisa foram&#44; sem ordem de import&#226;ncia&#58; &#8220;ataque &#43; card&#237;aco&#8221;&#44; &#8220;ataque &#43; cora&#231;&#227;o&#8221;&#44; &#8220;enfarte &#8211; cerebral&#8221; e &#8220;infarto &#8211; cerebral&#8221; &#40;de forma a excluir v&#237;deos referentes a acidentes vasculares cerebrais&#41;&#44; &#8220;enfarte &#43; mioc&#225;rdio&#8221;&#44; &#8220;enfarte &#43; agudo &#43; mioc&#225;rdio&#8221;&#44; &#8220;infarto &#43; mioc&#225;rdio&#8221;&#44; &#8220;infarto &#43; agudo &#43; mioc&#225;rdio&#8221;&#44; &#8220;trombose &#43; cora&#231;&#227;o&#8221; e &#8220;trombose &#43; coron&#225;ria&#8221;&#46; Exclu&#237;ram&#8208;se da pesquisa termos como &#8220;supradesnivelamento ST&#8221; ou &#8220;infradesnivelamento ST&#8221;&#44; pois n&#227;o s&#227;o frequentemente pesquisados pelo p&#250;blico geral&#46; Exclu&#237;ram&#8208;se ainda termos como &#8220;angina&#8221;&#44; &#8220;angina &#43; peito&#8221; ou &#8220;angor&#8221;&#44; dado o foco apenas no EAM&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os resultados da pesquisa de cada termo foram ordenados por relev&#226;ncia&#44; sem aplica&#231;&#227;o de outros filtros adicionais de pesquisa&#46; Os v&#237;deos apresentados ap&#243;s a posi&#231;&#227;o 100 nos resultados da pesquisa para cada termo foram exclu&#237;dos por se assumir uma baixa probabilidade de visualiza&#231;&#227;o pelos utilizadores a partir deste ponto&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Sele&#231;&#227;o dos v&#237;deos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Da sele&#231;&#227;o inicial de 1&#46;000 v&#237;deos &#40;10 termos x 100 primeiros v&#237;deos&#41; obtida com os diferentes termos de pesquisa&#44; exclu&#237;ram&#8208;se&#58; &#40;1&#41; os v&#237;deos assumidos como irrelevantes por n&#227;o abordarem o tema em estudo &#40;n &#61; 316&#41;&#44; &#40;2&#41; os v&#237;deos que n&#227;o se encontravam em l&#237;ngua portuguesa &#40;n &#61; 106&#41;&#44; &#40;3&#41; os v&#237;deos com problemas t&#233;cnicos ou sem &#225;udio por se admitir uma baixa ades&#227;o &#224; sua visualiza&#231;&#227;o &#40;n &#61; 24&#41; e &#40;4&#41; v&#237;deos duplicados ou repetidos entre pesquisas &#40;n &#61; 345&#44; neste caso o primeiro resultado foi analisado e os duplicados exclu&#237;dos&#41;&#46; Os v&#237;deos subdivididos em m&#250;ltiplas partes foram contabilizados como um &#250;nico v&#237;deo &#40;n &#61; 42&#41;&#46; Assim&#44; a nossa pesquisa retornou 242 v&#237;deos eleg&#237;veis&#46; A <a class="elsevierStyleCrossRef" href="#sec0100">Tabela Suplementar</a> 1 lista os 1000 v&#237;deos avaliados e a <a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a> resume o diagrama de fluxo de pesquisa e sele&#231;&#227;o de v&#237;deos&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Colheita de dados e classifica&#231;&#227;o dos v&#237;deos</span><p id="par0040" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o dos v&#237;deos eleg&#237;veis foi realizada por dois observadores m&#233;dicos internos de forma&#231;&#227;o espec&#237;fica &#40;IF e DM&#41;&#46; Registaram&#8208;se para cada v&#237;deo os seguintes par&#226;metros&#58; data de <span class="elsevierStyleItalic">upload&#44;</span> n&#250;mero de visualiza&#231;&#245;es&#44; dura&#231;&#227;o do v&#237;deo &#40;em minutos&#41; e opini&#227;o dos utilizadores &#40;sob a forma de <span class="elsevierStyleItalic">likes</span> e <span class="elsevierStyleItalic">dislikes</span>&#41;&#46; Nos v&#237;deos subdivididos em m&#250;ltiplas partes foi registada a data de <span class="elsevierStyleItalic">upload</span> do &#250;ltimo v&#237;deo e contabilizada a m&#233;dia de visualiza&#231;&#245;es e do r&#225;cio <span class="elsevierStyleItalic">like&#47;dislike&#46;</span> Foi ainda documentado se o v&#237;deo fornecia informa&#231;&#227;o em sa&#250;de ou n&#227;o&#44; o p&#250;blico&#8208;alvo &#40;doentes&#44; p&#250;blico geral ou profissionais de sa&#250;de&#41; e a tipologia do v&#237;deo &#40;humor&#237;stico&#44; musical&#44; anima&#231;&#227;o&#44; publicidade a um f&#225;rmaco&#44; hospital ou profissional&#44; ou regular &#8211; na qual se incluem os restantes v&#237;deos&#41;&#46; No caso de identifica&#231;&#227;o de m&#250;ltiplas tipologias para um mesmo v&#237;deo&#44; chegou&#8208;se a um consenso entre tr&#234;s investigadores &#40;IF&#44; DM e JBA&#41; sobre qual a tipologia principal que melhor representava o v&#237;deo analisado&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os v&#237;deos foram ainda caracterizados quanto &#224; sua fonte&#47;origem&#58; experi&#234;ncia pessoal&#44; cadeia de not&#237;cias&#44; programas televisivos de entretenimento&#44; sociedades cient&#237;ficas&#44; empresas farmac&#234;uticas&#44; faculdades ou centros de instru&#231;&#227;o&#44; institui&#231;&#245;es de sa&#250;de ou governamentais&#44; formadores individuais sem v&#237;nculo institucional ou outros media &#40;v&#237;deos n&#227;o inclu&#237;dos nas categorias anteriores&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">O conte&#250;do dos v&#237;deos foi avaliado no que diz respeito ao tema abordado&#58; fisiopatologia&#44; sinais e sintomas&#44; diagn&#243;stico&#44; tratamento&#44; medidas preventivas &#40;incluindo controlo dos fatores de risco cardiovasculares&#41; e complica&#231;&#245;es associadas&#46; Admitiu&#8208;se a possibilidade de o mesmo v&#237;deo abordar m&#250;ltiplos t&#243;picos&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A informa&#231;&#227;o foi analisada quanto &#224; presen&#231;a de imprecis&#245;es&#44; anotando&#8208;se o tipo de incorre&#231;&#227;o cl&#237;nica&#47;cient&#237;fica&#46; Avaliou&#8208;se ainda a credibilidade e qualidade da informa&#231;&#227;o atrav&#233;s dos scores <span class="elsevierStyleItalic">Health on the Net Code</span> &#40;HONCode&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> e DISCERN<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a>&#44; ambos baseados na informa&#231;&#227;o audiovisual de cada v&#237;deo&#46; A <span class="elsevierStyleItalic">Health on the Net</span> &#233; uma organiza&#231;&#227;o independente que fornece as <span class="elsevierStyleItalic">guidelines</span> de informa&#231;&#227;o em sa&#250;de para os <span class="elsevierStyleItalic">websites</span>&#44; baseando&#8208;se em oito princ&#237;pios&#58; autoridade&#44; complementaridade&#44; confidencialidade&#44; atributo &#40;origem da informa&#231;&#227;o&#41;&#44; justificabilidade &#40;evid&#234;ncia&#41;&#44; transpar&#234;ncia de autoria&#44; transpar&#234;ncia de patroc&#237;nio&#44; honestidade editorial e de conflitos de interesse&#46; Avali&#225;mos a ades&#227;o dos v&#237;deos eleg&#237;veis a cada um dos princ&#237;pios HONCode&#44; utilizando uma tabela adaptada para v&#237;deos <span class="elsevierStyleItalic">online</span> conforme previamente publicado<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a>&#44; e classific&#225;mos a qualidade dos v&#237;deos em baixa &#40;HONCode 0&#8208;2&#41;&#44; moderada &#40;HONCode 3&#8208;5&#41; ou alta &#40;HONCode 6&#8208;8&#41;&#46; Por sua vez&#44; o <span class="elsevierStyleItalic">score</span> DISCERN constitui um instrumento utilizado na avalia&#231;&#227;o da qualidade da informa&#231;&#227;o m&#233;dica escrita&#44; tendo sido adaptado &#224; avalia&#231;&#227;o dos v&#237;deos conforme previamente publicado<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a>&#46; Em v&#237;deos focados em considera&#231;&#245;es diagn&#243;sticas apenas s&#227;o aplic&#225;veis os primeiros 8 itens do DISCERN&#44; contrariamente aos v&#237;deos referentes &#224; abordagem terap&#234;utica&#44; nos quais todos os itens do DISCERN s&#227;o relevantes &#40;<a class="elsevierStyleCrossRef" href="#sec0100">Tabela Suplementar 2</a>&#41;&#46; Cada item recebe uma pontua&#231;&#227;o de 1 a 5&#44; em que 5 indica lacunas m&#237;nimas ou aus&#234;ncia de lacunas&#59; a qualidade dos v&#237;deos foi classificada em baixa &#40;DISCERN score 1&#41;&#44; moderada &#40;DISCERN score 2&#8208;4&#41; ou alta &#40;DISCERN score 5&#41;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lise estat&#237;stica</span><p id="par0060" class="elsevierStylePara elsevierViewall">A an&#225;lise estat&#237;stica foi realizada com recurso ao <span class="elsevierStyleItalic">software</span> SPSS para Windows&#44; vers&#227;o 22&#46;0 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46; As vari&#225;veis categ&#243;ricas s&#227;o apresentadas como frequ&#234;ncias absolutas com percentagens&#46; As vari&#225;veis cont&#237;nuas param&#233;tricas &#40;normalmente distribu&#237;das&#41; s&#227;o apresentadas como m&#233;dia &#177; desvio&#8208;padr&#227;o&#44; caso contr&#225;rio s&#227;o apresentadas como mediana e intervalo interquartil&#46; Testou&#8208;se a normalidade da distribui&#231;&#227;o das vari&#225;veis cont&#237;nuas com recurso ao teste de Kolmogorov&#8208;Smirnov e avalia&#231;&#227;o visual dos histogramas&#46; As compara&#231;&#245;es entre os grupos de v&#237;deos foram feitas com recurso a teste de qui&#8208;quadrado ou teste exato de Fisher para vari&#225;veis categ&#243;ricas&#44; conforme apropriado&#59; as vari&#225;veis cont&#237;nuas foram comparadas com recurso ao teste <span class="elsevierStyleItalic">t</span> de Student ou <span class="elsevierStyleItalic">one&#8208;way</span> Anova para vari&#225;veis param&#233;tricas&#59; as vari&#225;veis cont&#237;nuas n&#227;o param&#233;tricas foram avaliadas com o teste <span class="elsevierStyleItalic">U</span> de Mann&#8208;Whitney ou teste de Kruskal&#8208;Wallis&#44; conforme apropriado&#46; Foi avaliada a reprodutibilidade intra&#8208; e interobservador&#44; com recurso &#224; estat&#237;stica kappa de Cohen&#44; quanto &#224; audi&#234;ncia&#8208;alvo&#44; fonte&#44; tipologia do v&#237;deo&#44; tema abordado&#44; imprecis&#245;es e <span class="elsevierStyleItalic">scores</span> HONCode e DISCERN &#40;<a class="elsevierStyleCrossRef" href="#sec0100">Tabela Suplementar 3</a>&#41;&#46; Uma amostra aleat&#243;ria de 25 v&#237;deos eleg&#237;veis &#40;10&#37;&#41; foi utilizada para esse efeito&#46; A reprodutibilidade intraobservador foi avaliada com um intervalo temporal superior a um m&#234;s entre an&#225;lises&#46; Todos os testes estat&#237;sticos foram bilaterais e com um n&#237;vel de signific&#226;ncia de 5&#37;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Caracter&#237;sticas dos v&#237;deos</span><p id="par0065" class="elsevierStylePara elsevierViewall">Foram inclu&#237;dos na an&#225;lise final 242 v&#237;deos &#40;dura&#231;&#227;o m&#233;dia de 9&#44;2 &#177; 0&#44;8 minutos&#44; m&#237;nimo 0&#44;3 e m&#225;ximo 89&#44;3 minutos&#41;&#44; perfazendo 2&#46;226 minutos&#46; A mediana de dias decorridos desde o <span class="elsevierStyleItalic">upload</span> at&#233; &#224; an&#225;lise dos v&#237;deos foi de 823 &#40;384&#8211;1&#46;693&#41; dias&#44; a maioria dos quais &#40;75&#44;6&#37;&#41; submetidos h&#225; pelo menos um ano&#46; As caracter&#237;sticas gerais dos v&#237;deos inclu&#237;dos encontram&#8208;se resumidas na <a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#46; A concord&#226;ncia intra&#8208; e interobservador na avalia&#231;&#227;o e classifica&#231;&#227;o dos v&#237;deos foi boa ou excelente &#40;<a class="elsevierStyleCrossRef" href="#sec0100">Tabela Suplementar 3</a>&#41;&#46; O par&#226;metro que apresentou menor concord&#226;ncia interobservador foi o tema do v&#237;deo &#40;0&#44;63&#44; 0&#44;39&#8208;0&#44;87&#41; e o que apresentou maior concord&#226;ncia foi a presen&#231;a de imprecis&#245;es cl&#237;nicas ou cient&#237;ficas &#40;0&#44;84&#44; 0&#44;62&#8208;1&#44;00&#41;&#46; Quando identificadas discord&#226;ncias a avalia&#231;&#227;o final resultou de um consenso entre tr&#234;s investigadores &#40;IF&#44; DM e JBA&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">A maioria dos v&#237;deos destina&#8208;se ao p&#250;blico em geral &#40;n &#61; 199&#44; 77&#44;7&#37;&#41; e tem origem em formadores sem v&#237;nculo institucional &#40;n &#61; 95&#44; 39&#44;3&#37;&#41;&#59; estes &#250;ltimos apresentam a maior aprova&#231;&#227;o pelo p&#250;blico com um r&#225;cio <span class="elsevierStyleItalic">like&#47;dislike</span> de 44 &#40;19&#8722;77&#41;&#46; Por sua vez&#44; os v&#237;deos de institui&#231;&#245;es de sa&#250;de&#47;governamentais demonstram o pior r&#225;cio <span class="elsevierStyleItalic">like&#47;dislike</span> &#40;r&#225;cio <span class="elsevierStyleItalic">like&#47;dislike</span> 17&#44; 3&#8722;23&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Os v&#237;deos de programas televisivos de entretenimento s&#227;o tendencialmente mais longos &#40;13&#44;0 minutos&#44; 4&#44;0&#8722;21&#44;1&#41;&#46; V&#237;deos de &#8220;outros media&#8221; &#40;4&#44;2 minutos&#44; 3&#44;1&#8722;5&#44;5&#41; s&#227;o significativamente mais longos do que os v&#237;deos de institui&#231;&#245;es de sa&#250;de&#47;governamentais &#40;1&#44;8 minuto&#44; 0&#44;8&#8722;3&#44;2&#44; p &#61; 0&#44;002&#41;&#44; sociedades cient&#237;ficas &#40;1&#44;6 minuto&#44; 0&#44;9&#8722;6&#44;5&#44; p &#61; 0&#44;003&#41; e cadeias de not&#237;cias &#40;2&#44;8 minutos&#44; 2&#44;3&#8722;4&#44;1&#44; p &#61; 0&#44;010&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">V&#237;deos com origem em experi&#234;ncia pessoal s&#227;o os mais visualizados &#40;mediana de 63&#46;305 visualiza&#231;&#245;es&#44; 2&#46;112&#8722;683&#46;598&#41; bem como os mais comentados &#40;mediana 69 coment&#225;rios&#44; 2&#8211;593&#41;&#46; Os v&#237;deos de programas televisivos apresentaram um n&#250;mero de visualiza&#231;&#245;es &#40;mediana de 11&#46;396 visualiza&#231;&#245;es&#44; 1&#46;462&#8722;49&#46;073&#41; significativamente superior aos v&#237;deos de cadeias de not&#237;cias &#40;291 visualiza&#231;&#245;es&#44; 15&#8722;1&#46;083&#44; p &#61; 0&#44;001&#41;&#44; empresas farmac&#234;uticas &#40;70 visualiza&#231;&#245;es&#44; 25&#8722;128&#44; p &#61; 0&#44;010&#41; e sociedades cient&#237;ficas &#40;234 visualiza&#231;&#245;es&#44; 58&#8722;12&#46;963&#44; p&#61;0&#44;026&#41;&#46; V&#237;deos de formadores sem v&#237;nculo institucional t&#234;m um n&#250;mero de coment&#225;rios &#40;8 coment&#225;rios&#44; 1&#8208;64&#41; superior aos v&#237;deos de cadeias de not&#237;cias &#40;0 coment&#225;rios&#44; 0&#8722;0&#44; p &#61; 0&#44;002&#41;&#44; institui&#231;&#245;es de sa&#250;de&#47;governamentais &#40;0 coment&#225;rios&#44; 0&#8722;1&#44; p &#61; 0&#44;023&#41; e sociedades cient&#237;ficas &#40;0 coment&#225;rios&#44; 0&#8722;0&#44; p &#61; 0&#44;028&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conte&#250;do dos v&#237;deos</span><p id="par0085" class="elsevierStylePara elsevierViewall">Os temas dos v&#237;deos abordados de acordo com a fonte encontram&#8208;se resumidos na <a class="elsevierStyleCrossRef" href="#fig0010">Figura 2</a>&#46; O tema mais abordado foi &#8220;sinais e sintomas&#8221; &#40;62&#44;0&#37;&#44; n &#61; 150&#41;&#44; seguido de fisiopatologia &#40;55&#44;0&#37;&#44; n &#61; 133&#41;&#46; Os &#8220;sinais e sintomas&#8221; de EAM s&#227;o o tema mais abordado em v&#237;deos de sociedades cient&#237;ficas &#40;100&#44;0&#37;&#44; n &#61; 14&#41;&#44; experi&#234;ncia pessoal &#40;83&#44;3&#37;&#44; n &#61; 5&#41;&#44; cadeias de not&#237;cias &#40;76&#44;9&#37;&#44; n &#61; 10&#41;&#44; programas televisivos de entretenimento &#40;73&#44;0&#37;&#44; n &#61; 27&#41;&#44; institui&#231;&#245;es de sa&#250;de ou governamentais &#40;60&#44;0&#37;&#44; n &#61; 6&#41; e outros media &#40;65&#44;9&#37;&#44; n &#61; 29&#41;&#46; Por sua vez&#44; a fisiopatologia &#233; sobretudo focada em v&#237;deos de faculdades ou centros de instru&#231;&#227;o &#40;66&#44;7&#37;&#44; n &#61; 10&#41; e formadores sem v&#237;nculo institucional &#40;60&#44;0&#37;&#44; n &#61; 57&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Os temas dos v&#237;deos de acordo com o p&#250;blico&#8208;alvo encontram&#8208;se resumidos na <a class="elsevierStyleCrossRef" href="#fig0015">Figura 3</a><span class="elsevierStyleBold">&#46;</span> V&#237;deos dirigidos a profissionais de sa&#250;de focam maioritariamente a fisiopatologia &#40;60&#44;5&#37;&#44; n &#61; 23&#41;&#44; enquanto v&#237;deos dirigidos &#224; popula&#231;&#227;o geral abordam preferencialmente &#8220;sinais e sintomas&#8221; &#40;67&#44;8&#37;&#44; n &#61; 137&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Apenas 38&#44;8&#37; dos v&#237;deos inclu&#237;dos focam o tratamento &#40;n &#61; 94&#41; e a preven&#231;&#227;o &#40;n &#61; 94&#41; do EAM&#44; a maioria com origem em formadores sem v&#237;nculo institucional &#40;n &#61; 28 e n &#61; 32&#44; respetivamente&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Qualidade dos v&#237;deos</span><p id="par0100" class="elsevierStylePara elsevierViewall">A an&#225;lise da qualidade da informa&#231;&#227;o contida nos v&#237;deos de acordo com a fonte e tema abordado encontra&#8208;se detalhada na <a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#46; Um ter&#231;o dos v&#237;deos &#40;n &#61; 79&#44; 32&#44;6&#37;&#41; apresenta imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas&#44; a maioria dos quais com origem em formadores sem v&#237;nculo institucional &#40;n &#61; 33&#44; 41&#44;0&#37;&#41;&#46; O tema em que a imprecis&#227;o foi mais frequente foi &#8220;sinais e sintomas&#8221; &#40;n &#61; 46&#44; 58&#44;2&#37;&#41;&#46; V&#237;deos com origem em sociedades cient&#237;ficas e institui&#231;&#245;es de sa&#250;de ou governamentais n&#227;o apresentaram quaisquer imprecis&#245;es&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">A m&#233;dia dos <span class="elsevierStyleItalic">scores</span> HONCode e DISCERN foi 3&#44;0 &#177; 1&#44;1 e 2&#44;4 &#177; 0&#44;7&#44; respetivamente&#46; O n&#250;mero de v&#237;deos em conformidade com cada um dos princ&#237;pios HONCode &#233; apresentado na <a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#46; O princ&#237;pio HONCode mais respeitado foi o princ&#237;pio da confidencialidade &#40;n &#61; 223&#44; 95&#44;3&#37;&#41; e o menos respeitado foi o princ&#237;pio da justificabilidade&#47;refer&#234;ncias bibliogr&#225;ficas &#40;n &#61; 12&#44; 5&#44;1&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Na avalia&#231;&#227;o de qualidade com recurso ao HONCode&#44; os v&#237;deos de institui&#231;&#245;es de sa&#250;de&#47;governamentais apresentaram a melhor pontua&#231;&#227;o &#40;HONCode score 4&#177;1&#41;&#44; enquanto v&#237;deos com origem em experi&#234;ncia pessoal e cadeias de not&#237;cias foram os de pior qualidade &#40;HONCode score 2&#177;1&#41;&#46; A avalia&#231;&#227;o com recurso ao score DISCERN n&#227;o demonstrou diferen&#231;as estatisticamente significativas entre as diferentes fontes de v&#237;deo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o da qualidade dos v&#237;deos foi tamb&#233;m realizada ap&#243;s exclus&#227;o dos v&#237;deos com origem em experi&#234;ncia pessoal ou not&#237;cias&#44; por se considerar que n&#227;o foram realizados com objetivo pedag&#243;gico &#40;n &#61; 19&#41;&#46; Destes&#44; apenas tr&#234;s apresentavam imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas&#46; Os resultados desta suban&#225;lise &#40;Tabela Suplementar 4&#41; n&#227;o demonstraram altera&#231;&#245;es significativas face ao conjunto global dos v&#237;deos&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Apenas um v&#237;deo &#40;0&#44;4&#37;&#41; apresentou concomitantemente boa qualidade &#40;HONCode score alto e DISCERN score alto&#41; sem imprecis&#245;es cl&#237;nicas e cient&#237;ficas&#46; Foi tamb&#233;m avaliada a qualidade dos v&#237;deos de acordo com a dura&#231;&#227;o do v&#237;deo&#44; n&#250;mero de visualiza&#231;&#245;es&#44; r&#225;cio <span class="elsevierStyleItalic">like&#47;dislike</span> e n&#250;mero de coment&#225;rios&#46; Verificou&#8208;se que os v&#237;deos de maior dura&#231;&#227;o se associam a melhores scores HONCode &#40;r &#61; 0&#44;191&#44; p &#61; 0&#44;003&#41; e DISCERN &#40;r &#61; 0&#44;283&#44; p &#60; 0&#44;001&#41;&#46; Por outro lado&#44; as imprecis&#245;es cl&#237;nicas ou cient&#237;ficas aumentam em v&#237;deos com mais visualiza&#231;&#245;es &#40;r &#61; 0&#44;285&#44; p &#60; 0&#44;001&#41; e maior n&#250;mero de <span class="elsevierStyleItalic">likes</span> &#40;r &#61; 0&#44;289&#44; p &#60; 0&#44;001&#41;&#44; <span class="elsevierStyleItalic">dislikes</span> &#40;r &#61; 0&#44;181&#44; p &#61; 0&#44;005&#41; e coment&#225;rios &#40;r &#61; 0&#44;147&#44; p &#61; 0&#44;024&#41;&#46; A <a class="elsevierStyleCrossRef" href="#fig0020">Figura 4</a> apresenta o n&#250;mero de <span class="elsevierStyleItalic">likes</span> e visualiza&#231;&#245;es de acordo com a presen&#231;a de imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Qualidade dos v&#237;deos com melhor <span class="elsevierStyleItalic">ranking</span></span><p id="par0125" class="elsevierStylePara elsevierViewall">Para cada termo de pesquisa&#44; avaliou&#8208;se ainda a qualidade dos v&#237;deos com melhor <span class="elsevierStyleItalic">ranking</span> no Youtube por se admitir que s&#227;o estes os v&#237;deos visualizados pela maioria dos utilizadores&#46; Para tal&#44; consideraram&#8208;se os 10 primeiros resultados da pesquisa&#44; total de 100 v&#237;deos&#44; ordenados por ordem de relev&#226;ncia e sem os crit&#233;rios de exclus&#227;o inicialmente aplicados na amostra&#46; A preval&#234;ncia de imprecis&#245;es foi de 22&#44;0&#37; &#40;n &#61; 22&#41; e a m&#233;dia de scores HONCode e DISCERN foi 2&#44;9 &#177; 1&#44;2 e 2&#44;2 &#177; 0&#44;9&#44; respetivamente&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discuss&#227;o</span><p id="par0130" class="elsevierStylePara elsevierViewall">Neste trabalho foi avaliada a relev&#226;ncia e qualidade da informa&#231;&#227;o audiovisual cl&#237;nica&#47;cient&#237;fica sobre EAM dispon&#237;vel em l&#237;ngua portuguesa no <span class="elsevierStyleItalic">site</span> YouTube&#46; Verificou&#8208;se uma preval&#234;ncia significativa de &#8220;desinforma&#231;&#227;o&#8221;&#58; um ter&#231;o de v&#237;deos &#233; irrelevante e um ter&#231;o dos v&#237;deos relevantes apresenta informa&#231;&#227;o imprecisa&#46; No global&#44; a qualidade da informa&#231;&#227;o &#233; baixa ou moderada&#44; pelo que importa definir estrat&#233;gias de controlo de qualidade da informa&#231;&#227;o m&#233;dica <span class="elsevierStyleItalic">online</span>&#46;</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">&#8220;Desinforma&#231;&#227;o&#8221; em sa&#250;de</span><p id="par0135" class="elsevierStylePara elsevierViewall">A influ&#234;ncia da Internet na divulga&#231;&#227;o da informa&#231;&#227;o em sa&#250;de tem crescido de forma significativa nos &#250;ltimos anos&#46; Nos Estados Unidos da Am&#233;rica sabe&#8208;se que oito em cada dez utilizadores da Internet procuram informa&#231;&#227;o <span class="elsevierStyleItalic">online</span> relacionada com sa&#250;de&#44; a maioria em redes sociais<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a>&#44; e um ter&#231;o dos indiv&#237;duos que procuram este tipo de informa&#231;&#227;o f&#225;&#8208;lo antes de ser avaliado por um m&#233;dico<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">N&#227;o h&#225; d&#250;vida de que a Internet desempenha um papel determinante na difus&#227;o da informa&#231;&#227;o m&#233;dica &#224; popula&#231;&#227;o e na forma como esta perceciona a doen&#231;a&#46; Esta influ&#234;ncia pode&#44; contudo&#44; ser uma verdadeira amea&#231;a&#44; uma vez que a exposi&#231;&#227;o a informa&#231;&#227;o incorreta&#44; n&#227;o filtrada&#44; pode ter consequ&#234;ncias nefastas na sa&#250;de e rivalizar com o esfor&#231;o de melhoria da educa&#231;&#227;o para a sa&#250;de realizado nas &#250;ltimas d&#233;cadas&#46; Um dos maiores perigos <span class="elsevierStyleItalic">online</span> s&#227;o as <span class="elsevierStyleItalic">fake news</span>&#44; tantas vezes dif&#237;ceis de distinguir de informa&#231;&#227;o veros&#237;mil para indiv&#237;duos leigos em sa&#250;de&#46; Nesta &#233;poca em que se torna dif&#237;cil distinguir o que &#233; verdadeiro do que n&#227;o o &#233; em plataformas <span class="elsevierStyleItalic">online</span>&#44; torna&#8208;se fundamental fortalecer os sistemas de informa&#231;&#227;o e prote&#231;&#227;o do doente&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Os nossos resultados espelham bem este risco de desinforma&#231;&#227;o&#58; um ter&#231;o dos v&#237;deos selecionados foi irrelevante e a qualidade geral dos v&#237;deos sobre EAM em l&#237;ngua portuguesa &#233; reduzida&#46; Um ter&#231;o dos v&#237;deos apresentou imprecis&#245;es cl&#237;nicas ou cient&#237;ficas&#44; sobretudo no tema &#8220;sinais e sintomas&#8221;&#44; o que pode contribuir para o atraso no reconhecimento dos sintomas pelos doentes&#44; atraso no diagn&#243;stico cl&#237;nico e&#44; consequentemente&#44; agravamento do progn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46; A t&#237;tulo de exemplo&#44; um dos v&#237;deos avaliados com maior proje&#231;&#227;o &#40;3&#46;052&#44;443 visualiza&#231;&#245;es e 144&#46;000 <span class="elsevierStyleItalic">likes</span>&#41; apresenta score HONCode de 2 e graves imprecis&#245;es cl&#237;nicas&#44; afirmando que alguns alimentos podem substituir a interven&#231;&#227;o coron&#225;ria percut&#226;nea no tratamento do EAM&#59; um outro v&#237;deo com 1&#46;477&#44;347 visualiza&#231;&#245;es e 12&#46;000 <span class="elsevierStyleItalic">likes</span> apresenta um score HONCode de 1 e defende que a sintomatologia do EAM surge um m&#234;s antes do evento&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Verificou&#8208;se que as imprecis&#245;es aumentam com o n&#250;mero de visualiza&#231;&#245;es&#44; <span class="elsevierStyleItalic">likes&#44; dislikes</span> e coment&#225;rios&#44; o que parece refletir que v&#237;deos mais sensacionalistas e&#44; consequentemente&#44; com maior participa&#231;&#227;o por parte dos utilizadores&#44; apresentam tendencialmente maior n&#250;mero de erros&#46; Outros artigos tinham j&#225; corroborado esta informa&#231;&#227;o ao concluir que artigos sobre sa&#250;de com imprecis&#245;es t&#234;m uma probabilidade 28 vezes superior de ser partilhados <span class="elsevierStyleItalic">online</span> comparativamente aos artigos sem erros cl&#237;nicos ou cient&#237;ficos<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">O perigo das <span class="elsevierStyleItalic">fake news</span> no YouTube tem vindo a ser debatido noutros pa&#237;ses&#44; n&#227;o s&#243; no que respeita ao EAM<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> ou outras patologias cardiovasculares<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a>&#44; mas tamb&#233;m relativamente a outras situa&#231;&#245;es cl&#237;nicas&#44; como doen&#231;as respirat&#243;rias<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">14&#44;18&#8211;20</span></a>&#44; doen&#231;as gastrointestinais<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#8211;23</span></a>&#44; doen&#231;as ortop&#233;dicas<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">24&#44;25</span></a>&#44; vacina&#231;&#227;o<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> ou ressuscita&#231;&#227;o cardiopulmonar<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a>&#46; As conclus&#245;es destes trabalhos v&#227;o de encontro ao observado para a realidade portuguesa e alertam para a necessidade imperativa de melhorar a qualidade da informa&#231;&#227;o m&#233;dica nesta plataforma&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Solu&#231;&#245;es para a &#8220;desinforma&#231;&#227;o&#8221;</span><p id="par0160" class="elsevierStylePara elsevierViewall">O p&#250;blico&#8208;geral demonstra uma maior interatividade com v&#237;deos de pior qualidade enquanto os v&#237;deos de melhor qualidade s&#227;o os menos vistos&#46; Estes problemas s&#227;o potenciados pelo facto de as redes sociais e de partilha de conte&#250;do <span class="elsevierStyleItalic">online</span>&#44; como o YouTube&#44; permitirem que cada utilizador possa fazer o <span class="elsevierStyleItalic">upload</span> de conte&#250;dos sem a valida&#231;&#227;o pr&#233;via do seu conte&#250;do e veracidade<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a>&#46; A an&#225;lise do &#8220;top 10&#8221; dos v&#237;deos do YouTube revelou que um quinto destes v&#237;deos apresentou imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas e o HONCode m&#233;dio foi apenas moderado&#46; Numa &#233;poca em que a instantaneidade e a disponibilidade imediata da informa&#231;&#227;o s&#227;o sobejamente valorizadas&#44; seria particularmente importante que a informa&#231;&#227;o apresentada em primeiro lugar fosse de qualidade superior ao demonstrado neste subgrupo de v&#237;deos&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">No sentido de diminuir o risco de desinforma&#231;&#227;o em sa&#250;de no YouTube v&#225;rias medidas podem ser adotadas&#46; Uma vez que os v&#237;deos de melhor qualidade s&#227;o&#44; &#224; semelhan&#231;a de outros estudos&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8&#44;15&#44;16</span></a> os v&#237;deos de sociedades cient&#237;ficas e institui&#231;&#245;es de sa&#250;de&#44; seria importante aumentar o n&#250;mero de v&#237;deos destas fontes nas plataformas <span class="elsevierStyleItalic">online</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Tamb&#233;m o estabelecimento de parcerias entre sociedades cient&#237;ficas e os influentes <span class="elsevierStyleItalic">YouTubers</span> pode conferir visibilidade e contribuir para a divulga&#231;&#227;o massiva de informa&#231;&#227;o m&#233;dica de qualidade&#44; &#224; semelhan&#231;a do que j&#225; foi anteriormente realizado pela Sociedade Portuguesa de Cardiologia<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a>&#46; De igual forma&#44; a parceria entre sociedades cient&#237;ficas e sites governamentais de divulga&#231;&#227;o de informa&#231;&#227;o &#224; popula&#231;&#227;o&#44; com elevado n&#250;mero de visualiza&#231;&#245;es di&#225;rias&#44; e que contam com equipas especializadas na cria&#231;&#227;o de conte&#250;dos digitais e na comunica&#231;&#227;o com o cidad&#227;o&#44; permitem aliar informa&#231;&#227;o m&#233;dica de origem fidedigna com transmiss&#227;o de informa&#231;&#227;o apelativa e eficaz&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">A solu&#231;&#227;o passa tamb&#233;m por melhorar os sistemas de valida&#231;&#227;o da informa&#231;&#227;o m&#233;dica partilhada no YouTube&#44; nomeadamente com implanta&#231;&#227;o de sistemas de <span class="elsevierStyleItalic">peer review</span> e de sinaliza&#231;&#227;o de v&#237;deos com imprecis&#245;es cl&#237;nicas ou cient&#237;ficas ou&#44; por exemplo&#44; que n&#227;o cumpram os princ&#237;pios HONCode&#46; A revis&#227;o dos algoritmos de pesquisa do YouTube relativamente a informa&#231;&#227;o em sa&#250;de poderia tamb&#233;m contribuir para que os resultados apresentados em primeiro lugar fossem provenientes de fontes de informa&#231;&#227;o validadas&#44; cuja acuidade tenha sido confirmada&#46; Atualmente &#233; tamb&#233;m poss&#237;vel a utiliza&#231;&#227;o da intelig&#234;ncia artificial para a cria&#231;&#227;o de algoritmos autom&#225;ticos de exclus&#227;o de v&#237;deos do YouTube que n&#227;o cumpram os termos de utiliza&#231;&#227;o da plataforma<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a>&#44; que poderiam ser recodificados de modo a excluir dos resultados de pesquisa v&#237;deos com imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas&#46; Tamb&#233;m neste sentido&#44; a Organiza&#231;&#227;o Mundial de Sa&#250;de prop&#244;s &#224; entidade americana respons&#225;vel pela atribui&#231;&#227;o de endere&#231;os na Internet&#44; a <span class="elsevierStyleItalic">Internet Corporation for Assigned Names and Numbers&#44;</span> a cria&#231;&#227;o de um novo dom&#237;nio na Internet para utiliza&#231;&#227;o exclusiva por fontes de informa&#231;&#227;o m&#233;dica validadas&#44; que seria criteriosamente regulado e monitorizado para assegurar a qualidade da informa&#231;&#227;o partilhada<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a>&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Limita&#231;&#245;es</span><p id="par0175" class="elsevierStylePara elsevierViewall">O processo de avalia&#231;&#227;o dos v&#237;deos &#233; subjetivo&#44; por&#233;m a reprodutibilidade intra&#8208; e interobservador foi boa ou excelente&#46; A pesquisa de v&#237;deos restringiu&#8208;se a um curto per&#237;odo temporal e em regra existe <span class="elsevierStyleItalic">turnover</span> do top 100 dos resultados&#46; Contudo&#44; a mediana de tempo decorrido desde o <span class="elsevierStyleItalic">upload</span> de 823 &#40;384&#8211;1693&#41; dias leva a crer que o <span class="elsevierStyleItalic">turnover</span> n&#227;o seja assim t&#227;o r&#225;pido&#44; pelo que estes resultados parecem ser representativos de um per&#237;odo temporal superior ao avaliado&#46; N&#227;o &#233; poss&#237;vel obter informa&#231;&#227;o demogr&#225;fica dos espectadores de cada v&#237;deo&#44; nem &#233; poss&#237;vel determinar quantos portugueses acedem ao YouTube ou especificamente quais os termos mais pesquisados sobre este tema&#46; Embora os termos selecionados n&#227;o sejam exaustivos &#40;por exemplo&#44; n&#227;o foram pesquisadas abreviaturas como &#8220;EAM&#8221;&#41;&#44; julgamos que no geral ser&#227;o representativos das pesquisas efetuadas pelo p&#250;blico geral&#46; N&#227;o foi avaliado o impacto do YouTube na modifica&#231;&#227;o de comportamentos na popula&#231;&#227;o&#44; por&#233;m tal n&#227;o foi objetivo do estudo e poder&#225; ser avaliado em futuros trabalhos&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conclus&#245;es</span><p id="par0180" class="elsevierStylePara elsevierViewall">No global&#44; a qualidade da informa&#231;&#227;o audiovisual cl&#237;nica e cient&#237;fica sobre EAM dispon&#237;vel em l&#237;ngua portuguesa no <span class="elsevierStyleItalic">site</span> YouTube &#233; baixa ou moderada&#46; Existe uma preval&#234;ncia elevada de &#8220;desinforma&#231;&#227;o&#8221; sobre EAM&#58; um ter&#231;o dos v&#237;deos &#233; irrelevante e a informa&#231;&#227;o &#233; imprecisa em um ter&#231;o dos v&#237;deos relevantes&#46; Para agravar este panorama&#44; os v&#237;deos mais visualizados s&#227;o de fontes imprecisas e de menor qualidade&#46; &#201; necess&#225;rio repensar estrat&#233;gias de controlo de qualidade da informa&#231;&#227;o m&#233;dica <span class="elsevierStyleItalic">online</span>&#44; que tornem a comunica&#231;&#227;o em sa&#250;de transparente&#44; eficaz e de qualidade e&#44; assim&#44; contribuam para a melhoria da sa&#250;de cardiovascular da popula&#231;&#227;o&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Financiamento</span><p id="par0185" class="elsevierStylePara elsevierViewall">Os autores n&#227;o t&#234;m fontes de financiamento a declarar&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflitos de interesse</span><p id="par0190" class="elsevierStylePara elsevierViewall">Os autores n&#227;o t&#234;m conflitos de interesse a declarar&#46;</p></span></span>"
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              "titulo" => "Conte&#250;do dos v&#237;deos"
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              "titulo" => "Qualidade dos v&#237;deos"
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              "titulo" => "Qualidade dos v&#237;deos com melhor ranking"
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              "titulo" => "&#8220;Desinforma&#231;&#227;o&#8221; em sa&#250;de"
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            1 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Solu&#231;&#245;es para a &#8220;desinforma&#231;&#227;o&#8221;"
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              "titulo" => "Limita&#231;&#245;es"
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    "fechaRecibido" => "2020-07-09"
    "fechaAceptado" => "2020-11-15"
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            0 => "Enfarte agudo mioc&#225;rdio"
            1 => "YouTube"
            2 => "Educa&#231;&#227;o em sa&#250;de"
            3 => "Comunica&#231;&#227;o em sa&#250;de"
            4 => "Gest&#227;o de informa&#231;&#227;o m&#233;dica"
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          "clase" => "keyword"
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            0 => "Myocardial infarction"
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            2 => "Health education"
            3 => "Health communication"
            4 => "Health information management"
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      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o e objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A Internet &#233; fundamental na divulga&#231;&#227;o de informa&#231;&#227;o m&#233;dica&#46; Contudo&#44; a aus&#234;ncia de controlo de qualidade potencia a &#8220;desinforma&#231;&#227;o&#8221; da popula&#231;&#227;o&#46; Pretendemos caraterizar a relev&#226;ncia e qualidade da informa&#231;&#227;o sobre enfarte agudo do mioc&#225;rdio em l&#237;ngua portuguesa no site YouTube &#40;<span class="elsevierStyleInterRef" id="intr0005" href="http://www.youtube.com/">www&#46;youtube&#46;com</span>&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analisaram&#8208;se 1&#46;000 v&#237;deos correspondentes aos primeiros 100 resultados da pesquisa no YouTube dos termos&#58; &#8220;ataque &#43; card&#237;aco&#8221;&#44; &#8220;ataque &#43; cora&#231;&#227;o&#8221;&#44; &#8220;enfarte &#8208; cerebral&#8221;&#44; &#8220;infarto &#8208; cerebral&#8221;&#44; &#8220;enfarte &#43; mioc&#225;rdio&#8221;&#44; &#8220;enfarte &#43; agudo &#43; mioc&#225;rdio&#8221;&#44; &#8220;infarto &#43; mioc&#225;rdio&#8221;&#44; &#8220;infarto &#43; agudo &#43; mioc&#225;rdio&#8221;&#44; &#8220;trombose &#43; cora&#231;&#227;o&#8221; e &#8220;trombose &#43; coron&#225;ria&#8221;&#46; Exclu&#237;ram&#8208;se v&#237;deos irrelevantes &#40;n &#61; 316&#41;&#44; duplicados &#40;n &#61; 345&#41;&#44; sem &#225;udio &#40;n &#61; 24&#41; e de l&#237;ngua n&#227;o portuguesa &#40;n &#61; 106&#41;&#46; Os v&#237;deos eleg&#237;veis foram analisados quanto a origem&#44; tema&#44; p&#250;blico&#8208;alvo e imprecis&#245;es cient&#237;ficas&#46; A qualidade foi avaliada com os <span class="elsevierStyleItalic">scores</span> Health on the Net Code &#40;HONCode&#44; de 0&#8208;8&#41; e DISCERN &#40;0&#8208;5&#41; &#8211; quanto maior&#44; melhor a qualidade&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Inclu&#237;ram&#8208;se 242 v&#237;deos&#44; a maioria de formadores independentes &#40;n &#61; 95&#44; 39&#37;&#41; e destinados &#224; popula&#231;&#227;o&#8208;geral &#40;n &#61; 202&#44; 83&#44;5&#37;&#41;&#46; Um ter&#231;o &#40;n &#61; 79&#41; apresentou imprecis&#245;es&#59; v&#237;deos de sociedades cient&#237;ficas e institui&#231;&#245;es de sa&#250;de&#47;governamentais n&#227;o apresentaram quaisquer imprecis&#245;es&#46; A qualidade m&#233;dia foi baixa&#47;moderada&#59; apenas um v&#237;deo apresentou boa qualidade&#44; sem imprecis&#245;es&#46; Institui&#231;&#245;es de sa&#250;de&#47;governamentais foram a fonte com melhor qualidade &#40;HONCode 4&#177;1&#44; DISCERN 2&#177;1&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A informa&#231;&#227;o sobre enfarte agudo do mioc&#225;rdio em l&#237;ngua portuguesa &#233; irrelevante em um ter&#231;o dos casos e um ter&#231;o dos v&#237;deos relevantes &#233; impreciso&#46; A qualidade m&#233;dia da informa&#231;&#227;o &#233; reduzida&#44; sendo importante definir estrat&#233;gias de controlo de qualidade da informa&#231;&#227;o m&#233;dica <span class="elsevierStyleItalic">online</span>&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introdu&#231;&#227;o e objetivos"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclus&#245;es"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction and objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The Internet is a fundamental aspect of health information&#46; However&#44; the absence of quality control encourages misinformation&#46; We aim to assess the relevance and quality of acute myocardial infarction videos shared on YouTube &#40;<span class="elsevierStyleInterRef" id="intr0010" href="http://www.youtube.com/">www&#46;youtube&#46;com</span>&#41; in Portuguese&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">We analyzed 1&#44;000 videos corresponding to the first 100 search results on YouTube using the following terms &#40;in Portuguese&#41;&#58; &#8220;cardiac &#43; arrest&#8221;&#59; &#8220;heart &#43; attack&#8221;&#59; &#8220;heart &#43; thrombosis&#8221;&#59; &#8220;coronary &#43; thrombosis&#8221;&#59; &#8220;infarction &#8211; brain&#8221;&#44; &#8220;myocardial &#43; infarction&#8221; and &#8220;acute &#43; myocardial &#43; infarction&#8221;&#46; Irrelevant &#40;n&#61;316&#41;&#44; duplicated &#40;n&#61;345&#41;&#44; without audio &#40;n&#61;24&#41; or non&#8208;Portuguese &#40;n&#61;106&#41; videos were excluded&#46; Included videos were assessed according to source&#44; topic&#44; target audience and scientific inaccuracies&#46; Quality of information was assessed using The Health on the Net Code &#40;HONCode from 0 to 8&#41; and DISCERN &#40;from 0 to 5&#41; scores &#8211; the higher the score&#44; the better the quality&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">242 videos were included&#46; The majority were from independent instructors &#40;n&#61;95&#44; 39&#46;0&#37;&#41; and were addressed to the general population &#40;n&#61;202&#44; 83&#46;5&#37;&#41;&#46; One third of the videos &#40;n&#61;79&#41; contained inaccuracies while scientific society and governmental&#47;health institution videos had no inaccuracies&#46; The mean video quality was poor or moderate&#59; only one video was good quality without any inaccuracies&#46; Governmental&#47;health institutions were the source with the best quality videos &#40;HONCode 4&#177;1&#44; DISCERN 2&#177;1&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">One third of the videos had irrelevant information and one third of the relevant ones contained inaccuracies&#46; The average video quality was poor&#59; therefore it is important to define strategies to improve the quality of online health information&#46;</p></span>"
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Fluxograma de sele&#231;&#227;o dos v&#237;deos&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">1</span>33 v&#237;deos com crit&#233;rios de exclus&#227;o m&#250;ltiplos &#40;18 v&#237;deos irrelevantes e em l&#237;ngua n&#227;o portuguesa&#44; 14 v&#237;deos irrelevantes e sem &#225;udio&#44; um v&#237;deo sem &#225;udio e em l&#237;ngua n&#227;o portuguesa&#41;&#46;</p>"
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o do n&#250;mero de <span class="elsevierStyleItalic">likes</span> &#40;A&#41; e n&#250;mero de visualiza&#231;&#245;es &#40;B&#41; nos v&#237;deos com e sem imprecis&#245;es cl&#237;nicas&#47;cient&#237;ficas&#46;</p>"
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                  \t\t\t\t">N&#176; de visualiza&#231;&#245;es&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">63&#46;305 &#40;2&#46;112&#8208;683&#46;598&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">N&#176; de <span class="elsevierStyleItalic">likes</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;1&#8208;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;738 &#40;16&#8208;16&#46;500&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">N&#176; de <span class="elsevierStyleItalic">dislikes</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;1&#8208;736&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">R&#225;cio <span class="elsevierStyleItalic">like&#47;diskike</span>&nbsp;\t\t\t\t\t\t\n
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                  \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">N&#176; coment&#225;rios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69 &#40;2&#8208;593&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="10" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de v&#237;deo&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Regular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;82&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;92&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">m&#233;dia &#177; desvio&#8208; padr&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">m&#233;dia &#177; desvio&#8208; padr&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Experi&#234;ncia pessoal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#177; 1&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="left" valign="\n
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                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Cadeia de not&#237;cias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 1&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="left" valign="\n
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                  \t\t\t\t">2 &#177; 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
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Sociedades cient&#237;ficas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Empresas farmac&#234;uticas&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Faculdades ou centros de instru&#231;&#227;o&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Institui&#231;&#245;es de sa&#250;de&#47;governamentais&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Formadores individuais&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;41&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Outros media&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;38&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleItalic">Tema do v&#237;deo</span>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Fisiopatologia&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;41&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Sinais e sintomas&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;58&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#177; 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"><span class="elsevierStyleHsp" style=""></span>Diagn&#243;stico&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
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                  \t\t\t\t">3 &#177; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tratamento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#177; 1&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="left" valign="\n
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                  \t\t\t\t">2 &#177; 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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Preven&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#177; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#177; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#177; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">193 &#40;82&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Confidencialidade</span>A informa&#231;&#227;o disponibilizada no v&#237;deo respeita o car&#225;ter confidencial dos dados dos doentes &#8208; incluindo a sua identidade pessoal&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">223 &#40;95&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Atributo</span>A informa&#231;&#227;o apresentada no v&#237;deo &#233; acompanhada pelas respetivas refer&#234;ncias das fontes consultadas e&#44; quando poss&#237;vel&#44; do link HTML das mesmas&#46; A data em que cada p&#225;gina foi atualizada pela &#250;ltima vez dever&#225; ser exibida claramente&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21 &#40;9&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Justificabilidade</span>Quaisquer afirma&#231;&#245;es feitas sobre os benef&#237;cios e&#47;ou desempenho de um tratamento&#44; produto comercial ou servi&#231;o espec&#237;fico dever&#227;o ser acompanhadas das respetivas refer&#234;ncias bibliogr&#225;ficas ou link HTML das mesmas&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                      "doi" => "10.2196/jmir.1035"
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