Abstract
Health information is produced on the Internet without evaluating its quality. Incomplete, contradictory, incorrect, or incomprehensible information can be harmful to health. But quality information can bring benefits to both citizens and health managers. This chapter analyzes Brazilian initiatives to evaluate the quality of health information based on the three systematic reviews on the subject. We found that the Brazilian academic production in this field does not follow international trends. Two Brazilian institutional initiatives are in place, namely, the “Regional Medical Council of São Paulo” and the “Internet, Health, and Society Laboratory” (LaISS) of the Oswaldo Cruz Foundation. LaISS made two evaluations that followed international literature and introduced innovative methods. We conclude that the pre-Internet communication culture seems to predominate among Brazilian health officials. Information and communication technologies are of secondary importance to public health managers and researchers.
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Notes
- 1.
Chapter 15 addresses the theme of “massive open online courses” (MOOCs).
- 2.
The SciELO.org Portal offers more than 360 open-access journals. It is one of the main sources of Brazilian scientific information and encompasses a significant portion of the country’s academic production.
- 3.
In Brazil, there are other open-access multidisciplinary bibliographic databases, such as Oasis.Br, LivRe, and BDTD or disciplinary-specific databases. There are also institutional repositories from several Brazilian research institutions.
- 4.
Studies selected were Silva et al. (2005), Barbosa and Martins (2007), Gondim and Falcão (2007), Souza et al. (2008), Santos et al. (2010), Silva and Gubert (2010), Leite and Correia (2011), Carlini et al. (2012), Gondim et al. (2012), Lins and Marin (2012), Cubas and Felchner (2012), Silveira et al. (2012), Del Giglio et al. (2012), Mori et al. (2013), Bastos et al. (2014), Pithon et al. (2014), Sousa et al. (2015), Chaves et al. (2015), Monteiro et al. (2016), Paolucci et al. (2017), and Pereira Neto et al. (2017).
- 5.
The Oswaldo Cruz Foundation is one of the most important science and technology institutions in Latin America. It builds on the ideas of health promotion and social development, producing scientific and technological knowledge, and being an agent of citizenship. This is the official site: https://portal.fiocruz.br/en/content/foundation
- 6.
Physician Sérgio Arouca (1941/2003) provided theoretical insights and participated in the creation of the Unified Health System (SUS), a system that ensures comprehensive, universal, and equal access to the entire Brazilian population. It ranges from simple outpatient care to organ transplants (Law No. 8080 of 19 September 1990).
- 7.
“A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making” (Cochrane Library 2018).
- 8.
As of the writing of this chapter (October 2017), the Web of Science indicated that this article had been quoted about 800 times. It can therefore be considered the main reference in the field of evaluation of the quality of health information on the Internet.
- 9.
Web of Science indicates that this study published in 2015 was cited about 10 times (October 2017).
- 10.
- 11.
In the biomedical area, articles were published in the following journals: Arquivos Brasileiros de Oftalmologia (1); International Archives of Otorhinolaryngology (1); Revista da Associação Médica Brasileira (1); Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein (1); Revista Paulista de Pediatria (1); Revista Brasileira de Otorrinolaringologia (1); Revista Brasileira de Saúde Materno Infantil (1); Revista CEFAC, Associação Brasileira de Motricidade Orofacial (1); and Jornal de Pediatria (1).
- 12.
In the public health area, papers were published in the following journals: Revista de Saúde Pública (2), Ciências e Saúde Coletiva (2), Saúde em Debate (1), Trabalho Educação e Saúde (1), and Revista da Sociedade Brasileira de Medicina Tropical (1).
- 13.
In the other health areas, papers were published in the following journals: CoDAS, Jornal da Sociedade Brasileira de Fonoaudiologia (1); Revista Odonto Ciência (1); Acta Paulista de Enfermagem (1); Revista da Escola de Enfermagem da Universidade de São Paulo (1); and Dental Press Journal of Orthodontics (1).
- 14.
The HONcode of Conduct for medical and health websites (HONcode): https://www.hon.ch/HONcode/Webmasters/Conduct.html
- 15.
The DISCERN Instrument: http://www.discern.org.uk/discern_instrument.php
- 16.
The first section contains eight questions, namely: Are the aims clear? Does it achieve its aims? Is it relevant? Is it clear what sources of information were used to compile the publication (other than the author or producer)? Is it clear when the information used or reported in the publication was produced? Is it balanced and unbiased? Does it provide details of additional sources of support and information? Does it refer to areas of uncertainty?
- 17.
The second section contains seven questions, namely: Does it describe how each treatment works? Does it describe the benefits of each treatment? Does it describe the risks of each treatment? Does it describe what would happen if no treatment is used? Does it describe how the treatment choices affect overall quality of life? Is it clear that there may be more than one possible treatment choice? Does it provide support for shared decision-making?
- 18.
In this case, there are three options: “low, serious or extensive shortcomings”; “moderate, potentially important but not serious shortcomings”; and “high, minimal shortcomings.”
- 19.
The manual, available in Portuguese, is available at this website: http://www.cremesp.org.br/?siteAcao=PublicacoesConteudoSumario&id=26
- 20.
The Brazilian Civil Rights Framework for the Internet was enacted in April 2014 through Law 12.965. Its passage is discussed in Chap. 2.
- 21.
Resolution 97/2001 of CREMSP was published in the Official Gazette of the State of São Paulo (section 1 number 45) on March 9, 2001.
- 22.
The other two papers announce that the Manual of Ethical Principles for Medical and Health Websites on the Internet is annexed to this resolution and will become effective as of the date of its publication (March 9, 2001).
- 23.
The eight HONcode principles are authoritative, complementarity, privacy, attribution, justifiability, transparency, financial disclosure, and advertising policy. See https://www.hon.ch/HONcode/Webmasters/Conduct.html
- 24.
The issue of information security on the Internet is addressed in Chap. 11.
- 25.
Sole paragraph of Article 37 establishes that: “Distance medical care provided as per telemedicine or of another method will be subjected to the regulation of the Federal Council of Medicine.”
- 26.
In Portuguese, “Manguinhos” is the plural diminutive of the word “mangue,” which means “mangrove” in English, thus, “small mangrove.”
- 27.
The minimum wage is the lowest legally defined monetary payment that a worker must receive in a company for his services in Brazil for 1 month’s work. The minimum wage amount is defined by a national law decree and is reassessed annually based on the current cost of living of the population. Currently, the monthly minimum wage in Brazil is 954 reais, approximately 297 US Dollars, or 10 US dollars per day.
- 28.
Militia is the generic name of military or paramilitary organizations, not legally recognized, composed of ordinary armed citizens who fight with drug traffickers and police over power in the favelas of various Brazilian cities (Misse 2011).
- 29.
The Millennium Goals were enacted through the United Nations Millennium Declaration adopted by the 191 member states on September 8, 2000.
- 30.
- 31.
The National Household Sample Survey – PNAD of the Brazilian Institute of Geography and Statistics (IBGE), a body linked to the Brazilian Federal Government, investigates on a quarterly basis a set of situational information on the trends and fluctuations of the labor force and, annually, structural themes relevant to understanding the Brazilian socioeconomic reality. In 2016, the PNAD revealed that 44.5 million Brazilians received on average R$ 747 (about US$200/May 2018) per month, less than the minimum wage. Meanwhile, the country’s 889,000 highest paid people received an average of R$ 27,000 (about US$4000/May 2018) per month. That is, only 1% earns 36 times more than half the average worker does. The difference is evident when we find that the richest 10% keep 43% of all earnings.
- 32.
A Fiocruz unit focused on clinical research, teaching, reference services, and infectious diseases care.
- 33.
A Fiocruz unit that operates in the areas of research, technological development, and innovation, providing reference services for the diagnosis of infectious and genetic diseases and vector control.
- 34.
LASER is “a research, education, and advisory unit that aims to institutionalize, disseminate, and update the evaluation and monitoring of endemic process control programs.” For more information, see http://www6.ensp.fiocruz.br/laser/
- 35.
Residency aims to “promote the development of attributes for the higher education multiprofessional health team to work in the Family Health Teams and in the Family Health Support Centers (NASF).” For more information, see http://www.ensp.fiocruz.br/portal-ensp/ensino/cursos/index.php?idcurso=488&indtipo=2&menu=1213
- 36.
This information was retrieved from LaISS’ website: http://laiss.ensp.fiocruz.br/pesquisa/buscar
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Pereira Neto, A., Paolucci, R. (2019). Evaluation of the Quality of Health Information on the Internet: An Analysis of Brazillian Initiatives. In: Pereira Neto, A., Flynn, M. (eds) The Internet and Health in Brazil . Springer, Cham. https://doi.org/10.1007/978-3-319-99289-1_10
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