Performance of Large Language Artificial Intelligence Models on Clear Aligner Treatment: Evaluation of Accuracy and Readibility in Answering Questions for Patients

Performance of Large Language Artificial Intelligence Models on Clear Aligner Treatment: Evaluation of Accuracy and Readibility in Answering Questions for Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Performance of Large Language Artificial Intelligence Models on Clear Aligner Treatment: Evaluation of Accuracy and Readibility in Answering Questions for Patients Osman Bahadır TOPCU, Güneş Kadriye Tiftikçi, Merve Aksöz, Furkan Dindaroğlu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6732717/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Objective This study aims to scientifically evaluate the responses provided by ChatGPT 4o to patient-posed questions regarding clear aligner treatment and to investigate the impact of artificial intelligence on medical processes. Materials and Methods A survey of 200 patients collected questions about clear aligner treatment, identifying 29 frequently asked ones. Researchers added 14 additional questions, resulting in 43, categorized into usage, side effects/complications, treatment limitations, and others. These questions were posed to chatbot simultaneously. The chatbot’s responses were analyzed for narrative level, readability, informational accuracy, and plagiarism using scoring systems. The data underwent statistical analysis with SPSS V.22. Results The highest FKGL score was observed in usage-related questions (14.53 ± 8.88), while the highest FRES score was in the other group (54.30 ± 0.89). DISCERN, EQIP, and GQS scores were highest in the usage and side effect/complication groups. Correlation analysis showed the strongest correlation between similarity and FKGL (r= -0.391, p = 0.010). For the top 10 questions, the average FKGL was 13.37 ± 4.37, and the average FRES was 47.18 ± 23.69. Regression analysis identified no significant relationships. Conclusion ChatGPT 4o demonstrates potential as a supplementary tool in patient education under professional supervision. However, further research is required to optimize its application and ensure its reliability in clinical settings. Artificial intelligence ChatGPT Patient education Health informatics Clear aligner treatment Introduction Artificial intelligence (AI) refers to the capability of computers or computer-controlled robots to execute tasks that are characteristic of intelligent beings. Utilizing algorithms and computer programs, AI performs complex tasks, analyzes data, and resolves intricate problems. While AI has the potential to enhance system efficiency, it raises significant concerns regarding ethics and safety [ 1 ]. Recently, chatbots equipped with language learning capabilities have been developed to process extensive datasets and generate meaningful outputs on a variety of topics. These features allow chatbots to facilitate easy access to information, making them increasingly popular among users [ 2 ]. ChatGPT, an AI-driven language model developed by OpenAI, synthesizes written sources from the internet to generate coherent texts on specific queries. Its data sources include books, articles, and websites, and the model continuously updates its database to improve response quality [ 3 ]. AI-based systems, such as ChatGPT, are introducing innovative perspectives in healthcare. These systems efficiently address patients’ questions about treatment processes, simplify complex medical information, and reach a broad audience [ 4 , 5 ]. The integration of AI into healthcare has the potential to strengthen doctor-patient communication, facilitate access to accurate information, enhance healthcare infrastructure, reduce the workload of healthcare professionals, and deliver high-quality care to patients [ 5 , 6 ]. However, as patients increasingly rely on internet-based information before, during, and after treatments, it becomes imperative for physicians to evaluate the reliability of such information and educate patients about the risks of misinformation [ 7 , 8 ]. While chatbots are often preferred for their accessibility and conversational style, they pose ethical and safety concerns due to their occasional provision of incorrect or incomplete answers and fabricated references [ 9 ]. Clear aligners have gained significant popularity due to increasing aesthetic concerns and the demand for a more comfortable treatment experience. Despite some disadvantages compared to traditional brackets, clear aligners are favored for their discreet appearance and ease of use. They are custom-made for each patient and replaced at regular intervals [ 10 , 11 ]. However, as a technologically advanced and innovative treatment option, clear aligners frequently raise questions among patients. Similarly, ChatGPT, as an innovative tool requiring cautious use, warrants evaluation for its ability to address such patient queries [ 12 ]. Studies have explored chatbot-generated information on various orthodontic applications, including cleft lip and palate, orthognathic surgery, and temporary anchorage devices [ 13 – 15 ]. Patients seeking clear aligner treatment often turn to internet-based sources like Google, YouTube, and Instagram for information. However, these platforms present challenges in verifying the reliability of their content. Chatbots, offering refined and controllable responses, may serve as a reliable alternative information source. Encouraging patients to use chatbot under medical supervision has the potential to improve treatment management, reduce physicians’ workloads, and provide easy access to accurate information. This study aims to evaluate the responses provided by chatbot to questions related to clear aligner treatment. The analysis focuses on the quality and validity of the information, readability, plagiarism, and narrative complexity. The hypothesis of the study was that chatbot’s responses may have limitations in accuracy and reliability, they exhibit high readability and narrative quality. Material and Method This study was approved by the Ethics Committee of Ege University Faculty of Medicine and the study was conducted in accordance with the Declaration of Helsinki. This study utilized ChatGPT-4o, selected for its extensive and general-purpose database as well as its ease of access for users. The topic of clear aligner treatment was chosen due to its representation as a modern, technology-integrated treatment and its appeal to a patient population that is enthusiastic about utilizing the internet for information. Identification of Questions Related to Clear Aligners The questions were identified using a face-to-face survey technique. Preliminary interviews were conducted with patients visiting the Orthodontics Department of Ege University Faculty of Dentistry. A total of 200 patients (105 female, 95 male; mean age: 18.5 years; age range: 15–28), who were either interested in undergoing clear aligner treatment, currently receiving treatment, or had completed treatment, were included in the study. Each patient was asked to propose five questions they might search for online regarding clear aligner treatment. From the collected responses, the 29 most frequently asked questions were selected. Additionally, four orthodontists with varying levels of professional experience (13 years, 2.5 years, and 4 years) contributed 14 additional questions that were deemed important but not previously mentioned by patients. These additions enhanced the comprehensiveness of the question set. The identified 43 questions were categorized into four subheadings: 7 related to the usage of the appliances, 16 concerning side effects/complications, 10 addressing treatment limitations, and 10 classified as others (Table 1). The questionnaire used to collect patient-generated questions was specifically developed for this study and has not been previously published. (Suppl. 1) Collection of Questions via Chatbot Questions were posed to ChatGPT 4o by the same author without providing any additional commands. The questions were asked on the 24th November 2024, and the responses were recorded exactly as they were generated, without any further modifications or prompts. Evaluation Criteria Six different evaluation criteria were used to assess the responses to the 43 selected questions from the chatbot. The Flesch-Kincaid Reading Grade Level (FKRGL) index is a scoring system used to measure the readability or complexity level of a text. This index provides a reading level based on criteria such as sentence length and the number of words. The FKRGL index is calculated using the following formula: 0.39 (Total Words/Total Sentences) + 11.8 (Total Syllables/Total Words) − 15.59 The higher the FKRGL index, the more complex and difficult the text is to read. An FKRGL index below 12 corresponds to a 7th-grade reading level or lower, while an index above 16 requires advanced reading skills (Table 2). The Flesch Reading Ease Score (FRES) evaluates the readability of text by analyzing factors such as sentence length and word complexity. This score measures the reading difficulty of English texts and is presented as a numerical value, with higher scores indicating easier readability (Table 2). The Effective and Quality Information for Patients (EQIP) scoring tool was used to assess the quality and validity of the text. This tool consists of 36 questions. The first 14 questions address the general characteristics of the information, while the remaining questions focus on disease, procedure, or medication details. Each question offers four response options: "yes," "partly," "no," and "not applicable." The EQIP score is calculated using the following formula: EQIP Score = (("yes" x 1 + "partly" x 0.5) / (20 - "not applicable" x 1)) x 100 In this formula, each question carries equal weight, resulting in an EQIP score that reflects the document’s quality and effectiveness in healthcare communication. The DISCERN scoring system was employed to evaluate the quality of the text using 15 specific questions. It was designed to assess the accuracy and reliability of health-related information available on the internet. Additionally, the Global Quality Score (GQS) was used to rate the usefulness of ChatGPT's responses on a five-point scale (Table 2). To determine the level of plagiarism in the responses, similarity scores were calculated using a plagiarism-detection tool ( http://www.ithenticate.com ). Each response was evaluated individually, with similarity percentages assessed across four levels: 0–10% (high originality), 10–20% (acceptable similarity), 20–40% (high similarity), and above 40% (very high similarity). The scoring process was conducted by two independent researchers. Initially, the authors calibrated their assessments by agreeing on scores for 10 orthodontics-related questions. These agreed-upon questions were posed to chatbot, and the responses were scored independently by both researchers. Discrepancies between their assessments were identified and resolved through discussions, ensuring consensus was reached for all evaluations. Statistical Analysis The statistical analyses of the study were performed using SPSS V.22. Descriptive statistics of the data were reported as mean, standard deviation, median, minimum, and maximum. Normality distributions of the data were assessed using the Shapiro-Wilk test, which indicated that the data did not follow a normal distribution. Consequently, non-parametric tests were applied. The correlation between index scores was analyzed by calculating Spearman correlation coefficients. Differences between question groups were evaluated using the Kruskal-Wallis test; however, since no significant differences were found, post-hoc analyses were not performed. The top 10 most frequently asked questions by patients were listed, and descriptive statistics of the indexes were calculated. Additionally, descriptive statistics for each question group were determined. The Mann-Whitney U test was used to compare the most frequently asked questions with other questions. Linear regression analysis was performed to evaluate relationships between the indexes. The level of statistical significance was set at p < 0.05. Results Descriptive data for the evaluation scales and scores, grouped by different question categories, are presented in Table 3. The highest FKGL score was observed in the usage-related questions (14.53 ± 8.88), while the highest FRES score was found in the other question group (54.30 ± 0.89); the lowest score was observed in the usage group (40.97 ± 9.98). DISCERN, EQIP, and GQS scores were highest in the usage and side effect/complication groups; in the other group (81.83 ± 7.34) and the usage group (4.43 ± 0.535), respectively. When comparing question groups, differences in all scores were found to be statistically insignificant (p > 0.05). Correlation analysis revealed low correlations between the scores. The highest correlation was found between similarity and FKGL (r = -0.391, p = 0.010), followed by the correlation between DISCERN and FKGL (r = -0.354, p = 0.020) (Table 4). For the top 10 most frequently asked questions, the average FKGL score was 13.37 ± 4.37, and the average FRES score was 47.18 ± 23.69. The average EQIP score was 79.89 ± 3.63, while the GQS and DISCERN scores were 3.8 ± 0.91 and 3.5 ± 0.84, respectively. No significant differences were found between the top 10 questions and other questions across all scoring systems (p > 0.05) (Table 5). Regression analysis did not identify any significant relationships between the FRES, FKGL, and EQIP scores (p = 0.957; p = 0.082, respectively). Additionally, no significant relationship was found between EQIP and similarity based on regression analysis. Discussion Is artificial intelligence a friend or a foe? While there is no definitive answer to this question, the undeniable reality is that artificial intelligence is an inevitable part of our future. Understanding it well and being proactive about its effects on medical processes is a responsibility that falls upon healthcare professionals. A total of 43 questions about clear aligner treatment were posed to ChatGPT 4o, an artificial intelligence-based chatbot increasingly used in various aspects of medicine. The responses were evaluated using several scoring systems based on criteria such as readability, level of explanation, and quality of information in medical texts. For readability and explanation level, the FRES and FKGL scoring systems were employed, which quantify text features numerically. Chatbot provided responses with a narrative level suitable for university-level readers, though the readability was classified as 'difficult.' Further evaluation across different quality parameters offered a comprehensive perspective on information quality and examined the relationships between various dimensions of quality standards. Three distinct scoring systems were used for this purpose, designed to evaluate patient information brochures, educational materials, and written communication in healthcare. These systems not only assessed accuracy but also considered the meaningful flow of information, comprehensibility, systematic design, and suitability for patient understanding. Across all scoring systems, chatbot was found to provide high-quality information. The responses exhibited very low plagiarism rates, reflecting the software's ability to synthesize insights from diverse sources. In this study, the questions were categorized into four groups: usage, side effects/complications, treatment limits, and others. The highest FRES score, indicating readability, was observed in the usage group, while the highest FKGL score, reflecting the level of explanation, was noted in the side effects/complications group. These findings suggest an inverse relationship between explanation level and readability, with more detailed explanations being more difficult to read. Notably, no correlation was found between FRES and FKGL scores. Regarding information quality, the highest scores were observed in the usage category. This may reflect the greater availability of data and higher internet search volumes for topics related to appliance usage. Analysis of the top 10 most frequently asked questions revealed no significant differences in comparison to general questions, suggesting that differences in information quality may arise from variations in user preferences and search behaviors. Correlation analysis showed minimal relationships between different indices. An increase in information quality, typically expected to correlate with better explanation levels, was not observed. This lack of correlation may stem from each scoring system evaluating distinct aspects of information quality. Similarly, regression analysis identified no significant relationships among the FRES, FKGL, and EQIP scores or between EQIP scores and plagiarism similarity. Several studies have investigated chatbot’s performance in healthcare contexts. For instance, Sarah Abu Arqub et al. analyzed responses to 111 questions, reporting that 58% of answers were correct, 15% were incorrect, and no scientific references were provided. In contrast, this study emphasizes the comprehensibility, design consistency, and meaningful information flow rather than focusing solely on scientific accuracy [ 16 ]. Another study by Orlando Motohiro Tanaka et al. evaluated ChatGPT responses to orthodontic questions using a Likert scale. They found 71% of answers rated as 'very good' and 15% as 'good.' However, Likert scales rely on subjective evaluation, whereas this study employed objective numerical scoring systems, enhancing reproducibility and consistency [ 15 ]. Duran et al. explored the quality of information related to cleft lip and palate (CLP) and found similar challenges in readability and information quality. Despite differences in target populations, these findings align with the results of this study, reinforcing the importance of evaluating chatbot responses in specialized contexts [ 13 ]. Clear aligners were chosen as the focus of this study due to their increasing relevance, rising demand, and integration with internet-based searches. ChatGPT 4o demonstrated the capability to provide quick access to structured and comprehensible information, though its responses may lack the depth and personal engagement offered by healthcare professionals [ 17 , 18 ]. The potential of AI-based tools to complement clinical care necessitates further exploration to optimize their application in healthcare settings [ 19 ]. Conclusion The responses provided by chatbot to questions about clear aligners were identified as challenging to read but suitable for university and postgraduate-level comprehension. The quality and accuracy of the information were deemed high. Given the growing demand for clear aligners, assessing the quality and reliability of chatbot-generated responses across various clinical topics is crucial. Such evaluations will facilitate the integration of new technologies into doctor-patient collaboration, ultimately enhancing healthcare communication and decision-making. Abbreviations AI Artificial intelligence FKGL Flesch-Kincaid Grade Level FRES Flesch Reading Ease Score EQIP Ensuring Quality Information for Patients GQS Global Quality Score SPSS Statistical Package for the Social Sciences CLP Cleft Lip and Palate Declarations Ethical Approval and Consent to Participate Ethical approval was obtained from the institutional review committee of Ege University Faculty of Medicine. This study was conducted according to the Declaration of Helsinki. Informed consent form was obtained from all participants. For participants under the age of 16, informed consent was obtained from their parents or legal guardians. Content to Publish There is no consent to publish as no identifying information is included. Competing Interests The author declare that they have no competing interests. Funding The authors received no financial support for the research, authorship or publication of this article. Author Contribution Author ContributionsOsman Bahadır Topçu: Writing-review & editing, Writing-original draft, Data acquisition, ConceptualizationMerve Aksöz: Writing-review & editing , Writing-original draft, Data acquisition, Conceptualization.Kadriye Güneş Tiftikci: Writing-review & editing, Writing-original draft, , Conceptualization, Applied ethical approval.Furkan Dindaroğlu : Writing-review & editing, Statistical analyses, Conceptualization, Methodology, Supervision. Acknowledgements Not applicable. Data Availability The data supporting the findings of this study are available from the corresponding author upon reasonable request. References Deng J, Lin Y. 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Side effects/Complications May clear aligner treatment affect my speech? Side effects/Complications What are the side effects that I may encounter during clear aligner treatment? Is there any harm from clear aligner? Side effects/Complications Does clear aligner treatment cause my teeth to wobble and lead to tooth loss? Side effects/Complications Do clear aligners cause injury to soft tissues? Side effects/Complications My clear aligner is broken, what should I do? Side effects/Complications What should I do if I lose my clear aligners? Side effects/Complications My clear aligner does not fit, what should i do? Side effects/Complications My attachments fell off during my clear aligner treatment, what should I do? Side effects/Complications Can clear aligner treatment be applied at any age? Side effects/Complications Can clear aligner treatment be applied in all patients? Side effects/Complications Are there any medications I should not use during my clear aligner treatment? Side effects/Complications How much does clear aligner treatment cost? Other How long does clear aligner treatment last? Other Is clear aligner treatment as reliable as the braces? Other What are the advantages of clear aligner treatment compared to the braces? Other Can every dentist apply clear aligner treatment? Other In clear aligner treatment, is there a difference in success rate between different brands? Which criteria should I pay attention to when choosing a brand? Other What are clear aligners made of? Other Are the materials which the clear aligners are made carcinogenic? Other Will people be able to notice that I am wearing clear aligners? Other Doctor's Questions Category Does clear aligner treatment increase caries formation? Side effects/Complications Does clear aligner treatment increase tartar formation? Side effects/Complications Does clear aligner treatment cause allergies? Side effects/Complications How do clear aligners affect the jaw joint, do they cause pain in my jaw joint? Side effects/Complications Do clear aligners cause increased salivation? Side effects/Complications After my clear aligner treatment, my teeth returned to their pre-treatment position, what should I do? Side effects/Complications Is it possible to treat impacted teeth with clear aligner? Treatment Limits Are the positions of my jaws can change with a clear aligner treatment? Can my lower jaw be moved back with a clear aligner? Treatment Limits Can orthognathic surgery be performed with a clear aligners? Treatment Limits Can I have aligner treatment when I have a habit of grinding my teeth? Treatment Limits Can clear aligner treatment be applied in patients with cleft lip and palate? Treatment Limits Can I have clear aligner treatment when I have dry mouth? Treatment Limits Can clear aligners be used in patients with epilepsy? Treatment Limits After my clear aligner treatment, what should I do to prevent my teeth from returning to their pre-treatment position? Other Table 2. The Description of Flesch Reading Ease (FRES), Flesch Kincaid Reading Grade Level (FKGL) and Global Quality (GQS) Scale Estimated Reading Grade Estimated Reading Grade 90-100 Very Easy 5th Grade 80-90 Easy 6th Grade Reading Ease Score 70-80 Fairly Easy 7th Grade 60-70 Standard/Plain English 8th and 9th Grade 50-60 Fairly Difficult 10th to 12th Grade (High School Sophomore to Senior) 30-50 Difficult In College 0-30 College Graduate Collage Graduate Quality Assesment of the Content Information Coverage Patient Utility 1 Poor Quality None Very unlikely to be of any use to patients 2 Poor Quality Some information present Of very limited use to patients Global Quality Scale (GQS) 3 Suboptimal Flow Some information covered but important topics are missing Somewhat useful to patients 4 Good quality and flow Most important topic covered Useful to patients 5 Excellent quality and flow Most important topic covered Highly useful to patients Table 3. The descriptive statistics of parameters in question groups and the results of statistical comparisons between groups USAGE (N=7) SIDE EFFECTS/COMPLICATIONS (N=16) Minimum Maximum Mean Std.Deviation Median Minimum Maximum Mean Std.Deviation Median Flesch-Kincaid Grade Level (FKGL) 11.7 34.66 14.53 8.88 11.2 9.7 23.48 13.48 3.82 12.52 Flesch Reading Ease Score (FRES) 26.16 55.8 40.97 9.98 42.54 24.61 90.9 48.42 16.51 44.35 Discern 4 4 4 0 4 4 4 0 Effective and Quality Information for Patients (EQIP) 72.91 87.5 81.32 5.34 81.81 74.19 90.9 80.56 4.6 80.21 Global Quality Index (GQI) 4 5 4.43 0.53 4 2 5 3.81 0.91 4 Similarity 0 22 5.29 8.22 0 0 15 4.13 5.72 2 *The results of Kruskal Wallis Test TREATMENT LIMITATIONS (N=10) OTHER (N=10) Total (N=43) Minimum Maximum Mean Std. Deviation Median Minimum Maximum Mean Std. Deviation Median Minimum Maximum Mean Std. Deviation Median P* 9.28 14.4 12.17 1.47 12.1 9.1 23.36 13.43 4.13 12 9.1 34.66 13.33 4.6 12 0.83 11.6 99.6 46.84 23.34 44.91 32.96 69.67 54.3 10.89 56.21 11.6 99.6 48.21 16.48 46.13 0.17 3 4 3.9 0.31 2 4 3.5 0.85 4 2 4 3.86 0.46 4 0.05 72.58 84.61 77.06 3.41 4 76 100 81.83 7.34 79.32 72.58 100 80.17 5.38 79.63 0.11 2 5 3.3 0.94 3 2 5 3.9 1.1 4 2 5 3.81 0.95 4 0.1 0 17 2.9 5.72 0 0 24 4.8 7.48 1.5 0 24 4.19 6.4 0 0.82 Table 4. The results of correlation analysis among diffrent scales. Flesch-Kincaid Grade Level (FKGL) Flesch-Kincaid Reading Ease Score (FRES) Discern Effective and Quality Information for Patients (EQIP) Global Quality Score (GQS) Similarity Flesch-Kincaid Grade Level (FKGL) Correlation Coefficient 1 Sig.(2-tailed) . Flesch-Kincaid Reading Ease Score (FRES) Correlation Coefficient -0.30* 1 Sig.(2-tailed) 0.04 . Discern Correlation Coefficient -0.35* -0.08 1 Sig.(2-tailed) 0.02 0.59 . Effective and Quality Information for Patients (EQIP) Correlation Coefficient -0.33* -0.02 0.24 1 Sig.(2-tailed) 0.03 0.85 0.11 . Global Quality Score (GQS) Correlation Coefficient -0.04 -0.05 0.09 -0.17 1 Sig.(2-tailed) 0.76 0.74 0.55 0.26 . Similarity Correlation Coefficient 0.39 -0.11 -0.26 -0.09 -0.08 1 Sig.(2-tailed) 0.01 0.47 0.08 0.53 0.6 . * Correlation is significant at the 0.05 level (2-tailed). ** Correlation is significant at the 0.01 level (2-tailed). Table 5. The descriptive statistics of most frequesntly asked question and the others also the results of statatistical comparisons were shown Popular Questions* Other Questions Mean Difference p Minimum Maximum Mean Median Std.Deviation Minimum Maximum Mean Median Std.Deviation Flesch-Kincaid Grade Level (FKGL) 9.28 23.36 13.37 11.25 4.37 9.10 34.66 13.33 12 4.73 0.04 0.68 Flesch Reading Ease Score (FRES) 11.61 99.61 47.18 45.82 23.69 26.16 90.9 48.52 46.28 14.09 -1.33 0.72 Discern 2 4 3.5 4 0.84 3 4 3.97 4 0.17 -0.47 0.19 Effective and Quality Information for Patients (EQIP) 76.19 87.5 79.89 78.86 3.63 72.58 100 80.25 80 5.85 -0.35 0.74 Global Quality Score (GQS) 2 5 3.8 4 0.91 2 5 3.82 4 0.98 -0.01 0.92 Similarity 0 24 4.4 0 7.6 0 22 4.12 0 6.13 0.27 0.96 *Most frequently asked 10 questions by patients. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6732717","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":483529571,"identity":"a977348f-b826-44cf-866c-dfac60c4a464","order_by":0,"name":"Osman Bahadır TOPCU","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Osman","middleName":"Bahadır","lastName":"TOPCU","suffix":""},{"id":483529572,"identity":"b3fe2200-277a-4ca9-bee6-ffdb7648af4f","order_by":1,"name":"Güneş Kadriye Tiftikçi","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Güneş","middleName":"Kadriye","lastName":"Tiftikçi","suffix":""},{"id":483529573,"identity":"65d1b5c7-96f1-4029-b229-84c3e58aff5e","order_by":2,"name":"Merve Aksöz","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Merve","middleName":"","lastName":"Aksöz","suffix":""},{"id":483529574,"identity":"22798a06-7146-4ec6-acb2-581bdb3d3077","order_by":3,"name":"Furkan Dindaroğlu","email":"data:image/png;base64,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","orcid":"","institution":"Ege University","correspondingAuthor":true,"prefix":"","firstName":"Furkan","middleName":"","lastName":"Dindaroğlu","suffix":""}],"badges":[],"createdAt":"2025-05-23 12:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6732717/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6732717/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86535888,"identity":"ab49138e-46b1-4fe9-a03f-d585bd0d28bd","added_by":"auto","created_at":"2025-07-11 18:24:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1447928,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6732717/v1/752b8b74-f68f-41fe-aa8a-a1c3b25343bd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePerformance of Large Language Artificial Intelligence Models on Clear Aligner Treatment: Evaluation of Accuracy and Readibility in Answering Questions for Patients\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eArtificial intelligence (AI) refers to the capability of computers or computer-controlled robots to execute tasks that are characteristic of intelligent beings. Utilizing algorithms and computer programs, AI performs complex tasks, analyzes data, and resolves intricate problems. While AI has the potential to enhance system efficiency, it raises significant concerns regarding ethics and safety [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Recently, chatbots equipped with language learning capabilities have been developed to process extensive datasets and generate meaningful outputs on a variety of topics. These features allow chatbots to facilitate easy access to information, making them increasingly popular among users [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eChatGPT, an AI-driven language model developed by OpenAI, synthesizes written sources from the internet to generate coherent texts on specific queries. Its data sources include books, articles, and websites, and the model continuously updates its database to improve response quality [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAI-based systems, such as ChatGPT, are introducing innovative perspectives in healthcare. These systems efficiently address patients\u0026rsquo; questions about treatment processes, simplify complex medical information, and reach a broad audience [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The integration of AI into healthcare has the potential to strengthen doctor-patient communication, facilitate access to accurate information, enhance healthcare infrastructure, reduce the workload of healthcare professionals, and deliver high-quality care to patients [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, as patients increasingly rely on internet-based information before, during, and after treatments, it becomes imperative for physicians to evaluate the reliability of such information and educate patients about the risks of misinformation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. While chatbots are often preferred for their accessibility and conversational style, they pose ethical and safety concerns due to their occasional provision of incorrect or incomplete answers and fabricated references [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eClear aligners have gained significant popularity due to increasing aesthetic concerns and the demand for a more comfortable treatment experience. Despite some disadvantages compared to traditional brackets, clear aligners are favored for their discreet appearance and ease of use. They are custom-made for each patient and replaced at regular intervals [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. However, as a technologically advanced and innovative treatment option, clear aligners frequently raise questions among patients. Similarly, ChatGPT, as an innovative tool requiring cautious use, warrants evaluation for its ability to address such patient queries [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStudies have explored chatbot-generated information on various orthodontic applications, including cleft lip and palate, orthognathic surgery, and temporary anchorage devices [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Patients seeking clear aligner treatment often turn to internet-based sources like Google, YouTube, and Instagram for information. However, these platforms present challenges in verifying the reliability of their content. Chatbots, offering refined and controllable responses, may serve as a reliable alternative information source. Encouraging patients to use chatbot under medical supervision has the potential to improve treatment management, reduce physicians\u0026rsquo; workloads, and provide easy access to accurate information.\u003c/p\u003e\u003cp\u003eThis study aims to evaluate the responses provided by chatbot to questions related to clear aligner treatment. The analysis focuses on the quality and validity of the information, readability, plagiarism, and narrative complexity. The hypothesis of the study was that chatbot\u0026rsquo;s responses may have limitations in accuracy and reliability, they exhibit high readability and narrative quality.\u003c/p\u003e"},{"header":"Material and Method","content":"\u003cp\u003e This study was approved by the Ethics Committee of Ege University Faculty of Medicine and the study was conducted in accordance with the Declaration of Helsinki. This study utilized ChatGPT-4o, selected for its extensive and general-purpose database as well as its ease of access for users. The topic of clear aligner treatment was chosen due to its representation as a modern, technology-integrated treatment and its appeal to a patient population that is enthusiastic about utilizing the internet for information.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eIdentification of Questions Related to Clear Aligners\u003c/h2\u003e\u003cp\u003eThe questions were identified using a face-to-face survey technique. Preliminary interviews were conducted with patients visiting the Orthodontics Department of Ege University Faculty of Dentistry. A total of 200 patients (105 female, 95 male; mean age: 18.5 years; age range: 15\u0026ndash;28), who were either interested in undergoing clear aligner treatment, currently receiving treatment, or had completed treatment, were included in the study. Each patient was asked to propose five questions they might search for online regarding clear aligner treatment. From the collected responses, the 29 most frequently asked questions were selected. Additionally, four orthodontists with varying levels of professional experience (13 years, 2.5 years, and 4 years) contributed 14 additional questions that were deemed important but not previously mentioned by patients. These additions enhanced the comprehensiveness of the question set. The identified 43 questions were categorized into four subheadings: 7 related to the usage of the appliances, 16 concerning side effects/complications, 10 addressing treatment limitations, and 10 classified as others (Table\u0026nbsp;1).\u003c/p\u003e\u003cp\u003eThe questionnaire used to collect patient-generated questions was specifically developed for this study and has not been previously published. (Suppl. 1)\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eCollection of Questions via Chatbot\u003c/h3\u003e\n\u003cp\u003eQuestions were posed to ChatGPT 4o by the same author without providing any additional commands. The questions were asked on the 24th November 2024, and the responses were recorded exactly as they were generated, without any further modifications or prompts.\u003c/p\u003e\n\u003ch3\u003eEvaluation Criteria\u003c/h3\u003e\n\u003cp\u003eSix different evaluation criteria were used to assess the responses to the 43 selected questions from the chatbot. The Flesch-Kincaid Reading Grade Level (FKRGL) index is a scoring system used to measure the readability or complexity level of a text. This index provides a reading level based on criteria such as sentence length and the number of words. The FKRGL index is calculated using the following formula:\u003c/p\u003e\u003cp\u003e0.39 (Total Words/Total Sentences)\u0026thinsp;+\u0026thinsp;11.8 (Total Syllables/Total Words) \u0026minus;\u0026thinsp;15.59\u003c/p\u003e\u003cp\u003eThe higher the FKRGL index, the more complex and difficult the text is to read. An FKRGL index below 12 corresponds to a 7th-grade reading level or lower, while an index above 16 requires advanced reading skills (Table\u0026nbsp;2).\u003c/p\u003e\u003cp\u003eThe Flesch Reading Ease Score (FRES) evaluates the readability of text by analyzing factors such as sentence length and word complexity. This score measures the reading difficulty of English texts and is presented as a numerical value, with higher scores indicating easier readability (Table\u0026nbsp;2).\u003c/p\u003e\u003cp\u003eThe Effective and Quality Information for Patients (EQIP) scoring tool was used to assess the quality and validity of the text. This tool consists of 36 questions. The first 14 questions address the general characteristics of the information, while the remaining questions focus on disease, procedure, or medication details. Each question offers four response options: \"yes,\" \"partly,\" \"no,\" and \"not applicable.\" The EQIP score is calculated using the following formula:\u003c/p\u003e\u003cp\u003eEQIP Score = ((\"yes\" x 1 + \"partly\" x 0.5) / (20 - \"not applicable\" x 1)) x 100\u003c/p\u003e\u003cp\u003eIn this formula, each question carries equal weight, resulting in an EQIP score that reflects the document\u0026rsquo;s quality and effectiveness in healthcare communication.\u003c/p\u003e\u003cp\u003eThe DISCERN scoring system was employed to evaluate the quality of the text using 15 specific questions. It was designed to assess the accuracy and reliability of health-related information available on the internet.\u003c/p\u003e\u003cp\u003eAdditionally, the Global Quality Score (GQS) was used to rate the usefulness of ChatGPT's responses on a five-point scale (Table\u0026nbsp;2).\u003c/p\u003e\u003cp\u003eTo determine the level of plagiarism in the responses, similarity scores were calculated using a plagiarism-detection tool (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.ithenticate.com\u003c/span\u003e\u003cspan address=\"http://www.ithenticate.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). Each response was evaluated individually, with similarity percentages assessed across four levels: 0\u0026ndash;10% (high originality), 10\u0026ndash;20% (acceptable similarity), 20\u0026ndash;40% (high similarity), and above 40% (very high similarity).\u003c/p\u003e\u003cp\u003eThe scoring process was conducted by two independent researchers. Initially, the authors calibrated their assessments by agreeing on scores for 10 orthodontics-related questions. These agreed-upon questions were posed to chatbot, and the responses were scored independently by both researchers. Discrepancies between their assessments were identified and resolved through discussions, ensuring consensus was reached for all evaluations.\u003c/p\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eThe statistical analyses of the study were performed using SPSS V.22. Descriptive statistics of the data were reported as mean, standard deviation, median, minimum, and maximum. Normality distributions of the data were assessed using the Shapiro-Wilk test, which indicated that the data did not follow a normal distribution. Consequently, non-parametric tests were applied. The correlation between index scores was analyzed by calculating Spearman correlation coefficients. Differences between question groups were evaluated using the Kruskal-Wallis test; however, since no significant differences were found, post-hoc analyses were not performed. The top 10 most frequently asked questions by patients were listed, and descriptive statistics of the indexes were calculated. Additionally, descriptive statistics for each question group were determined. The Mann-Whitney U test was used to compare the most frequently asked questions with other questions. Linear regression analysis was performed to evaluate relationships between the indexes. The level of statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eDescriptive data for the evaluation scales and scores, grouped by different question categories, are presented in Table\u0026nbsp;3. The highest FKGL score was observed in the usage-related questions (14.53\u0026thinsp;\u0026plusmn;\u0026thinsp;8.88), while the highest FRES score was found in the other question group (54.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89); the lowest score was observed in the usage group (40.97\u0026thinsp;\u0026plusmn;\u0026thinsp;9.98). DISCERN, EQIP, and GQS scores were highest in the usage and side effect/complication groups; in the other group (81.83\u0026thinsp;\u0026plusmn;\u0026thinsp;7.34) and the usage group (4.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.535), respectively. When comparing question groups, differences in all scores were found to be statistically insignificant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eCorrelation analysis revealed low correlations between the scores. The highest correlation was found between similarity and FKGL (r = -0.391, p\u0026thinsp;=\u0026thinsp;0.010), followed by the correlation between DISCERN and FKGL (r = -0.354, p\u0026thinsp;=\u0026thinsp;0.020) (Table\u0026nbsp;4).\u003c/p\u003e\u003cp\u003eFor the top 10 most frequently asked questions, the average FKGL score was 13.37\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37, and the average FRES score was 47.18\u0026thinsp;\u0026plusmn;\u0026thinsp;23.69. The average EQIP score was 79.89\u0026thinsp;\u0026plusmn;\u0026thinsp;3.63, while the GQS and DISCERN scores were 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91 and 3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84, respectively. No significant differences were found between the top 10 questions and other questions across all scoring systems (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;5).\u003c/p\u003e\u003cp\u003eRegression analysis did not identify any significant relationships between the FRES, FKGL, and EQIP scores (p\u0026thinsp;=\u0026thinsp;0.957; p\u0026thinsp;=\u0026thinsp;0.082, respectively). Additionally, no significant relationship was found between EQIP and similarity based on regression analysis.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIs artificial intelligence a friend or a foe? While there is no definitive answer to this question, the undeniable reality is that artificial intelligence is an inevitable part of our future. Understanding it well and being proactive about its effects on medical processes is a responsibility that falls upon healthcare professionals.\u003c/p\u003e\u003cp\u003eA total of 43 questions about clear aligner treatment were posed to ChatGPT 4o, an artificial intelligence-based chatbot increasingly used in various aspects of medicine. The responses were evaluated using several scoring systems based on criteria such as readability, level of explanation, and quality of information in medical texts. For readability and explanation level, the FRES and FKGL scoring systems were employed, which quantify text features numerically. Chatbot provided responses with a narrative level suitable for university-level readers, though the readability was classified as 'difficult.'\u003c/p\u003e\u003cp\u003eFurther evaluation across different quality parameters offered a comprehensive perspective on information quality and examined the relationships between various dimensions of quality standards. Three distinct scoring systems were used for this purpose, designed to evaluate patient information brochures, educational materials, and written communication in healthcare. These systems not only assessed accuracy but also considered the meaningful flow of information, comprehensibility, systematic design, and suitability for patient understanding. Across all scoring systems, chatbot was found to provide high-quality information. The responses exhibited very low plagiarism rates, reflecting the software's ability to synthesize insights from diverse sources.\u003c/p\u003e\u003cp\u003eIn this study, the questions were categorized into four groups: usage, side effects/complications, treatment limits, and others. The highest FRES score, indicating readability, was observed in the usage group, while the highest FKGL score, reflecting the level of explanation, was noted in the side effects/complications group. These findings suggest an inverse relationship between explanation level and readability, with more detailed explanations being more difficult to read. Notably, no correlation was found between FRES and FKGL scores.\u003c/p\u003e\u003cp\u003eRegarding information quality, the highest scores were observed in the usage category. This may reflect the greater availability of data and higher internet search volumes for topics related to appliance usage. Analysis of the top 10 most frequently asked questions revealed no significant differences in comparison to general questions, suggesting that differences in information quality may arise from variations in user preferences and search behaviors.\u003c/p\u003e\u003cp\u003eCorrelation analysis showed minimal relationships between different indices. An increase in information quality, typically expected to correlate with better explanation levels, was not observed. This lack of correlation may stem from each scoring system evaluating distinct aspects of information quality. Similarly, regression analysis identified no significant relationships among the FRES, FKGL, and EQIP scores or between EQIP scores and plagiarism similarity.\u003c/p\u003e\u003cp\u003eSeveral studies have investigated chatbot\u0026rsquo;s performance in healthcare contexts. For instance, Sarah Abu Arqub et al. analyzed responses to 111 questions, reporting that 58% of answers were correct, 15% were incorrect, and no scientific references were provided. In contrast, this study emphasizes the comprehensibility, design consistency, and meaningful information flow rather than focusing solely on scientific accuracy [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAnother study by Orlando Motohiro Tanaka et al. evaluated ChatGPT responses to orthodontic questions using a Likert scale. They found 71% of answers rated as 'very good' and 15% as 'good.' However, Likert scales rely on subjective evaluation, whereas this study employed objective numerical scoring systems, enhancing reproducibility and consistency [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDuran et al. explored the quality of information related to cleft lip and palate (CLP) and found similar challenges in readability and information quality. Despite differences in target populations, these findings align with the results of this study, reinforcing the importance of evaluating chatbot responses in specialized contexts [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eClear aligners were chosen as the focus of this study due to their increasing relevance, rising demand, and integration with internet-based searches. ChatGPT 4o demonstrated the capability to provide quick access to structured and comprehensible information, though its responses may lack the depth and personal engagement offered by healthcare professionals [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The potential of AI-based tools to complement clinical care necessitates further exploration to optimize their application in healthcare settings [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe responses provided by chatbot to questions about clear aligners were identified as challenging to read but suitable for university and postgraduate-level comprehension. The quality and accuracy of the information were deemed high. Given the growing demand for clear aligners, assessing the quality and reliability of chatbot-generated responses across various clinical topics is crucial. Such evaluations will facilitate the integration of new technologies into doctor-patient collaboration, ultimately enhancing healthcare communication and decision-making.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eArtificial intelligence\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFKGL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eFlesch-Kincaid Grade Level\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFRES\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eFlesch Reading Ease Score\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEQIP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEnsuring Quality Information for Patients\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGQS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlobal Quality Score\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCLP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCleft Lip and Palate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical Approval and Consent to Participate\u003c/h2\u003e\u003cp\u003e Ethical approval was obtained from the institutional review committee of Ege University Faculty of Medicine. This study was conducted according to the Declaration of Helsinki. Informed consent form was obtained from all participants. For participants under the age of 16, informed consent was obtained from their parents or legal guardians.\u003c/p\u003e\u003ch2\u003eContent to Publish\u003c/h2\u003e\u003cp\u003e There is no consent to publish as no identifying information is included.\u003c/p\u003e\u003ch2\u003eCompeting Interests\u003c/h2\u003e\u003cp\u003eThe author declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThe authors received no financial support for the research, authorship or publication of this article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthor ContributionsOsman Bahadır Top\u0026ccedil;u: Writing-review \u0026amp; editing, Writing-original draft, Data acquisition, ConceptualizationMerve Aks\u0026ouml;z: Writing-review \u0026amp; editing , Writing-original draft, Data acquisition, Conceptualization.Kadriye G\u0026uuml;neş Tiftikci: Writing-review \u0026amp; editing, Writing-original draft, , Conceptualization, Applied ethical approval.Furkan Dindaroğlu : Writing-review \u0026amp; editing, Statistical analyses, Conceptualization, Methodology, Supervision.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDeng J, Lin Y. 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Front Artif Intell. 2023;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/frai.2023.1234567\u003c/span\u003e\u003cspan address=\"10.3389/frai.2023.1234567\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"636\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1. The List of Questions and Its Related Categories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 521px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatients\u0026apos;s Questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow should I eat during my clear aligner treatment? Is there anything i should not eat?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow should I clean my clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan I drink tea and coffee with my clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan I smoke with my clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDo I have to wear my clear aligners all day?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan I chew gum with my clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow often should I visit my doctor during clear aligner treatment?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUsage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eIs clear aligner treatment painful?\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDo clear aligners cause bad breath?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eMay clear aligner treatment affect my speech?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eWhat are the side effects that I may encounter during clear aligner treatment? Is there any harm from clear aligner?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDoes clear aligner treatment cause my teeth to wobble and lead to tooth loss?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDo clear aligners cause injury to soft tissues?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eMy clear aligner is broken, what should I do?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eWhat should I do if I lose my clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eMy clear aligner does not fit, what should i do?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eMy attachments fell off during my clear aligner treatment, what should I do?\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan clear aligner treatment be applied at any age?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan clear aligner treatment be applied in all patients?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eAre there any medications I should not use during my clear aligner treatment?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow much does clear aligner treatment cost?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow long does clear aligner treatment last?\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eIs clear aligner treatment as reliable as the braces?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eWhat are the advantages of clear aligner treatment compared to the braces?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan every dentist apply clear aligner treatment?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eIn clear aligner treatment, is there a difference in success rate between different brands? Which criteria should I pay attention to when choosing a brand?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eWhat are clear aligners made of?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eAre the materials which the clear aligners are made carcinogenic?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eWill people be able to notice that I am wearing clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 521px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDoctor\u0026apos;s Questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDoes clear aligner treatment increase caries formation?\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDoes clear aligner treatment increase tartar formation?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDoes clear aligner treatment cause allergies?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eHow do clear aligners affect the jaw joint, do they cause pain in my jaw joint?\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eDo clear aligners cause increased salivation?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eAfter my clear aligner treatment, my teeth returned to their pre-treatment position, what should I do?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eSide effects/Complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eIs it possible to treat impacted teeth with clear aligner?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eAre the positions of my jaws can change with a clear aligner treatment? Can my lower jaw be moved back with a clear aligner?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan orthognathic surgery be performed with a clear aligners?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan I have aligner treatment when I have a habit of grinding my teeth?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan clear aligner treatment be applied in patients with cleft lip and palate?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan I have clear aligner treatment when I have dry mouth?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eCan clear aligners be used in patients with epilepsy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eTreatment Limits\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 521px;\"\u003e\n \u003cp\u003eAfter my clear aligner treatment, what should I do to prevent my teeth from returning to their pre-treatment position?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 536px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2. The Description of Flesch Reading Ease (FRES), Flesch Kincaid Reading Grade Level (FKGL) and Global Quality (GQS) Scale\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 536px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEstimated Reading Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEstimated Reading Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e90-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eVery Easy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e5th Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e80-90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eEasy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e6th Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReading Ease Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e70-80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eFairly Easy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e7th Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e60-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eStandard/Plain English\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e8th and 9th Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e50-60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 206px;\"\u003e\n \u003cp\u003eFairly Difficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 273px;\"\u003e\n \u003cp\u003e10th to 12th Grade (High School Sophomore to Senior)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e30-50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eDifficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eIn College\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eCollege Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eCollage Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuality Assesment of the Content\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInformation Coverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Utility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003ePoor Quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eVery unlikely to be of any use to patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003ePoor Quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSome information present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eOf very limited use to patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal Quality Scale (GQS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eSuboptimal Flow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSome information covered but important topics are missing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eSomewhat useful to patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eGood quality and flow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eMost important topic covered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eUseful to patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 206px;\"\u003e\n \u003cp\u003eExcellent quality and flow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003eMost important topic covered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eHighly useful to patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"787\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"bottom\" style=\"width: 615px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3. The descriptive statistics of parameters in question groups and the results of statistical comparisons between groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 271px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUSAGE (N=7)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 271px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSIDE EFFECTS/COMPLICATIONS (N=16)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003eStd.Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003eStd.Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Grade Level (FKGL)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp; 11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp; 34.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;14.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;8.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;23.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;13.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp; 12.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch Reading Ease Score (FRES)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;26.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;55.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;40.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;42.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;24.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;48.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;16.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e44.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiscern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffective and Quality Information for Patients (EQIP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;72.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;81.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;81.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;74.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;80.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;80.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal Quality Index (GQI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimilarity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;8.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e*The results of Kruskal Wallis Test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"793\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTREATMENT LIMITATIONS (N=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 245px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOTHER (N=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (N=43)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eStd. Deviation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;P*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp; 9.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;14.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;12.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;12.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;23.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e13.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;34.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;13.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp; 11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;99.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;46.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e23.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;44.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;32.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e69.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;10.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;56.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;99.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;48.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;16.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;46.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e72.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e84.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e77.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e81.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;7.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;79.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;72.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;80.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;79.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;7.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"631\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 315px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4. The results of correlation analysis among diffrent scales.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Grade Level (FKGL)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Reading Ease Score (FRES)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiscern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffective and Quality Information for Patients (EQIP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal Quality Score (GQS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimilarity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Grade Level (FKGL)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Reading Ease Score (FRES)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.30*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiscern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.35*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffective and Quality Information for Patients (EQIP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.33*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal Quality Score (GQS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimilarity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003eSig.(2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e* Correlation is significant at the 0.05 level (2-tailed).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e** Correlation is significant at the 0.01 level (2-tailed).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"786\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"bottom\" style=\"width: 543px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5. The descriptive statistics of \u0026nbsp;most frequesntly asked question and the others also the results of statatistical comparisons were shown\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 67px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 249px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePopular Questions*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 249px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinimum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaximum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd.Deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinimum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaximum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd.Deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch-Kincaid Grade Level (FKGL)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;23.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;13.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;11.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;9.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e34.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e13.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFlesch Reading Ease Score (FRES)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;11.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;99.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;47.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;45.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;23.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e26.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e48.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e46.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;14.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;-1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiscern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffective and Quality Information for Patients (EQIP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;76.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;79.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;78.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e72.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e80.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal Quality Score \u0026nbsp; \u0026nbsp; (GQS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimilarity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;6.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e*Most frequently asked 10 questions by patients.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 67px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 52px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 67px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Artificial intelligence, ChatGPT, Patient education, Health informatics, Clear aligner treatment","lastPublishedDoi":"10.21203/rs.3.rs-6732717/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6732717/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aims to scientifically evaluate the responses provided by ChatGPT 4o to patient-posed questions regarding clear aligner treatment and to investigate the impact of artificial intelligence on medical processes.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eA survey of 200 patients collected questions about clear aligner treatment, identifying 29 frequently asked ones. Researchers added 14 additional questions, resulting in 43, categorized into usage, side effects/complications, treatment limitations, and others. These questions were posed to chatbot simultaneously. The chatbot\u0026rsquo;s responses were analyzed for narrative level, readability, informational accuracy, and plagiarism using scoring systems. The data underwent statistical analysis with SPSS V.22.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe highest FKGL score was observed in usage-related questions (14.53\u0026thinsp;\u0026plusmn;\u0026thinsp;8.88), while the highest FRES score was in the other group (54.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89). DISCERN, EQIP, and GQS scores were highest in the usage and side effect/complication groups. Correlation analysis showed the strongest correlation between similarity and FKGL (r= -0.391, p\u0026thinsp;=\u0026thinsp;0.010). For the top 10 questions, the average FKGL was 13.37\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37, and the average FRES was 47.18\u0026thinsp;\u0026plusmn;\u0026thinsp;23.69. Regression analysis identified no significant relationships.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eChatGPT 4o demonstrates potential as a supplementary tool in patient education under professional supervision. However, further research is required to optimize its application and ensure its reliability in clinical settings.\u003c/p\u003e","manuscriptTitle":"Performance of Large Language Artificial Intelligence Models on Clear Aligner Treatment: Evaluation of Accuracy and Readibility in Answering Questions for Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-11 18:08:41","doi":"10.21203/rs.3.rs-6732717/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"162795418020537666196841346388002815123","date":"2026-05-15T14:03:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T08:46:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130540600926828288638092646610734119476","date":"2026-05-09T08:31:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"306477281403308399346945570161427828869","date":"2026-05-06T07:25:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-13T02:29:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"194039697104013946983261059400032838946","date":"2025-07-28T05:14:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-09T11:17:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-02T13:24:59+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-30T09:57:15+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-30T07:34:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-05-30T07:31:04+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"78ae658f-81c5-4b84-aebe-aa0da58287ea","owner":[],"postedDate":"July 11th, 2025","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"162795418020537666196841346388002815123","date":"2026-05-15T14:03:22+00:00","index":95,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T08:46:30+00:00","index":94,"fulltext":""},{"type":"reviewerAgreed","content":"130540600926828288638092646610734119476","date":"2026-05-09T08:31:05+00:00","index":93,"fulltext":""},{"type":"reviewerAgreed","content":"306477281403308399346945570161427828869","date":"2026-05-06T07:25:24+00:00","index":91,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-11T18:08:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-11 18:08:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6732717","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6732717","identity":"rs-6732717","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}