diff --git a/Open-Source-Technology-in-Clinical-Data-Analysis.docx b/Open-Source-Technology-in-Clinical-Data-Analysis.docx
index 98c2997..ebb47c8 100644
Binary files a/Open-Source-Technology-in-Clinical-Data-Analysis.docx and b/Open-Source-Technology-in-Clinical-Data-Analysis.docx differ
diff --git a/Open-Source-Technology-in-Clinical-Data-Analysis.pdf b/Open-Source-Technology-in-Clinical-Data-Analysis.pdf
index 09ab4a1..5484305 100644
Binary files a/Open-Source-Technology-in-Clinical-Data-Analysis.pdf and b/Open-Source-Technology-in-Clinical-Data-Analysis.pdf differ
diff --git a/index.html b/index.html
index 37b27f5..586ab1c 100644
--- a/index.html
+++ b/index.html
@@ -193,7 +193,13 @@
         <li class="sidebar-item">
   <div class="sidebar-item-container"> 
   <a href="./why.html" class="sidebar-item-text sidebar-link">
- <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span></a>
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
   </div>
 </li>
         <li class="sidebar-item">
diff --git a/intro.html b/intro.html
index 8bc39ef..8ae2870 100644
--- a/intro.html
+++ b/intro.html
@@ -159,7 +159,13 @@
         <li class="sidebar-item">
   <div class="sidebar-item-container"> 
   <a href="./why.html" class="sidebar-item-text sidebar-link">
- <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span></a>
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
   </div>
 </li>
         <li class="sidebar-item">
diff --git a/references.html b/references.html
index 4f28194..881e0d7 100644
--- a/references.html
+++ b/references.html
@@ -49,7 +49,7 @@
 <script src="site_libs/quarto-search/fuse.min.js"></script>
 <script src="site_libs/quarto-search/quarto-search.js"></script>
 <meta name="quarto:offset" content="./">
-<link href="./why.html" rel="prev">
+<link href="./trust.html" rel="prev">
 <script src="site_libs/quarto-html/quarto.js"></script>
 <script src="site_libs/quarto-html/popper.min.js"></script>
 <script src="site_libs/quarto-html/tippy.umd.min.js"></script>
@@ -177,7 +177,13 @@
         <li class="sidebar-item">
   <div class="sidebar-item-container"> 
   <a href="./why.html" class="sidebar-item-text sidebar-link">
- <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span></a>
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
   </div>
 </li>
         <li class="sidebar-item">
@@ -456,8 +462,8 @@ <h1 class="title">References</h1>
 </script>
 <nav class="page-navigation">
   <div class="nav-page nav-page-previous">
-      <a href="./why.html" class="pagination-link">
-        <i class="bi bi-arrow-left-short"></i> <span class="nav-page-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span>
+      <a href="./trust.html" class="pagination-link">
+        <i class="bi bi-arrow-left-short"></i> <span class="nav-page-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span>
       </a>          
   </div>
   <div class="nav-page nav-page-next">
diff --git a/search.json b/search.json
index f26e0c7..d47ffa5 100644
--- a/search.json
+++ b/search.json
@@ -13,39 +13,74 @@
     "section": "1.1 Purpose and Background",
     "text": "1.1 Purpose and Background\nThere are many questions around understanding and using open source for clinical data analysis. We want to create a comprehesive knowledge base about the “state of the union” and provide an overview and ideally also answers for core questions. We need and collect input from our community to compile the knowledge base, so please join the discussions to allow a broad and complete picutre.\nIf you like to know more, please join the R/Pharma talk “The State of Open Source Technology in Clinical Data Analysis, Reporting, and Submissions”. The recording is here: 2023 R/Pharma presentation."
   },
+  {
+    "objectID": "summary.html",
+    "href": "summary.html",
+    "title": "2  What is Open Source?",
+    "section": "",
+    "text": "3 What is Open Source?\nWhen someone says ‘open source’ - what does that mean to you?\nWhat are the important characteristics of something that is regarded as ‘open source’?"
+  },
   {
     "objectID": "summary.html#contribute",
     "href": "summary.html#contribute",
     "title": "2  What is Open Source?",
-    "section": "2.1 Contribute",
-    "text": "2.1 Contribute\nContribute to the discussion here:\nWhat is open source?"
+    "section": "3.1 Contribute",
+    "text": "3.1 Contribute\nContribute to the discussion here:\nWhat is open source?"
   },
   {
     "objectID": "summary.html#guidance",
     "href": "summary.html#guidance",
     "title": "2  What is Open Source?",
-    "section": "2.2 Guidance",
-    "text": "2.2 Guidance\n\nProvide your thoughts and perspectives\nProvide references to articles, webinars, presentations (citations, links)\nBe respectful in this community"
+    "section": "3.2 Guidance",
+    "text": "3.2 Guidance\n\nProvide your thoughts and perspectives\nProvide references to articles, webinars, presentations (citations, links)\nBe respectful in this community"
   },
   {
     "objectID": "summary.html#examples",
     "href": "summary.html#examples",
     "title": "2  What is Open Source?",
-    "section": "2.3 Examples",
-    "text": "2.3 Examples\nExample 1: The Open Source Initiative provides a definition:\n\nFree distribution\nAvailable source code\nDerived works possible\n\nExample 2: Merriam-Webster defines open source as “having the source code freely available for possible modification and redistribution”."
+    "section": "3.3 Examples",
+    "text": "3.3 Examples\nExample 1: The Open Source Initiative provides a definition:\n\nFree distribution\nAvailable source code\nDerived works possible\n\nExample 2: Merriam-Webster defines open source as “having the source code freely available for possible modification and redistribution”."
+  },
+  {
+    "objectID": "why.html",
+    "href": "why.html",
+    "title": "3  Why Open Source?",
+    "section": "",
+    "text": "4 What is the ‘why’ for using open source solutions in pharma clinical data analytics?"
   },
   {
     "objectID": "why.html#contribute",
     "href": "why.html#contribute",
-    "title": "3  What is the ‘why’ for using open source solutions in pharma clinical data analytics?",
-    "section": "3.1 Contribute",
-    "text": "3.1 Contribute\nContribute to the discussion here:\nWhat is they ‘why’ for open source?"
+    "title": "3  Why Open Source?",
+    "section": "4.1 Contribute",
+    "text": "4.1 Contribute\nContribute to the discussion here:\nWhat is the ‘why’ for open source?"
   },
   {
     "objectID": "why.html#guidance",
     "href": "why.html#guidance",
-    "title": "3  What is the ‘why’ for using open source solutions in pharma clinical data analytics?",
-    "section": "3.2 Guidance",
-    "text": "3.2 Guidance\n\nProvide your thoughts and perspectives\nProvide references to articles, webinars, presentations (citations, links)\nBe respectful in this community"
+    "title": "3  Why Open Source?",
+    "section": "4.2 Guidance",
+    "text": "4.2 Guidance\n\nProvide your thoughts and perspectives\nProvide references to articles, webinars, presentations (citations, links)\nBe respectful in this community"
+  },
+  {
+    "objectID": "trust.html",
+    "href": "trust.html",
+    "title": "4  Establishing Trust",
+    "section": "",
+    "text": "5 Can an open source solution be trusted?"
+  },
+  {
+    "objectID": "trust.html#contribute",
+    "href": "trust.html#contribute",
+    "title": "4  Establishing Trust",
+    "section": "5.1 Contribute",
+    "text": "5.1 Contribute\nContribute to the discussion here:\nCan an open source solution be trusted to be accurate?"
+  },
+  {
+    "objectID": "trust.html#guidance",
+    "href": "trust.html#guidance",
+    "title": "4  Establishing Trust",
+    "section": "5.2 Guidance",
+    "text": "5.2 Guidance\n\nProvide your thoughts and perspectives\nProvide references to articles, webinars, presentations (citations, links)\nBe respectful in this community"
   }
 ]
\ No newline at end of file
diff --git a/summary.html b/summary.html
index f695614..09d2e41 100644
--- a/summary.html
+++ b/summary.html
@@ -159,7 +159,13 @@
         <li class="sidebar-item">
   <div class="sidebar-item-container"> 
   <a href="./why.html" class="sidebar-item-text sidebar-link">
- <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span></a>
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
   </div>
 </li>
         <li class="sidebar-item">
@@ -178,9 +184,12 @@
     <h2 id="toc-title">Table of contents</h2>
    
   <ul>
-  <li><a href="#contribute" id="toc-contribute" class="nav-link active" data-scroll-target="#contribute"><span class="header-section-number">2.1</span> Contribute</a></li>
-  <li><a href="#guidance" id="toc-guidance" class="nav-link" data-scroll-target="#guidance"><span class="header-section-number">2.2</span> Guidance</a></li>
-  <li><a href="#examples" id="toc-examples" class="nav-link" data-scroll-target="#examples"><span class="header-section-number">2.3</span> Examples</a></li>
+  <li><a href="#what-is-open-source" id="toc-what-is-open-source" class="nav-link active" data-scroll-target="#what-is-open-source"><span class="header-section-number">3</span> What is Open Source?</a>
+  <ul class="collapse">
+  <li><a href="#contribute" id="toc-contribute" class="nav-link" data-scroll-target="#contribute"><span class="header-section-number">3.1</span> Contribute</a></li>
+  <li><a href="#guidance" id="toc-guidance" class="nav-link" data-scroll-target="#guidance"><span class="header-section-number">3.2</span> Guidance</a></li>
+  <li><a href="#examples" id="toc-examples" class="nav-link" data-scroll-target="#examples"><span class="header-section-number">3.3</span> Examples</a></li>
+  </ul></li>
   </ul>
 </nav>
     </div>
@@ -204,6 +213,8 @@ <h1 class="title"><span class="chapter-number">2</span>&nbsp; <span class="chapt
 
 </header>
 
+<section id="what-is-open-source" class="level1" data-number="3">
+<h1 data-number="3"><span class="header-section-number">3</span> What is Open Source?</h1>
 <p>When someone says ‘open source’ - what does that mean to you?<br>
 What are the important characteristics of something that is regarded as ‘open source’?</p>
 <ul>
@@ -212,21 +223,21 @@ <h1 class="title"><span class="chapter-number">2</span>&nbsp; <span class="chapt
 <li>Does the ability to reuse the code matter?</li>
 <li>Does the ability to modify the code matter?</li>
 </ul>
-<section id="contribute" class="level2" data-number="2.1">
-<h2 data-number="2.1" class="anchored" data-anchor-id="contribute"><span class="header-section-number">2.1</span> Contribute</h2>
+<section id="contribute" class="level2" data-number="3.1">
+<h2 data-number="3.1" class="anchored" data-anchor-id="contribute"><span class="header-section-number">3.1</span> Contribute</h2>
 <p>Contribute to the discussion here:<br>
 <a href="https://github.com/phuse-org/OSTCDA/discussions/1">What is open source?</a></p>
 </section>
-<section id="guidance" class="level2" data-number="2.2">
-<h2 data-number="2.2" class="anchored" data-anchor-id="guidance"><span class="header-section-number">2.2</span> Guidance</h2>
+<section id="guidance" class="level2" data-number="3.2">
+<h2 data-number="3.2" class="anchored" data-anchor-id="guidance"><span class="header-section-number">3.2</span> Guidance</h2>
 <ul>
 <li><p>Provide your thoughts and perspectives</p></li>
 <li><p>Provide references to articles, webinars, presentations (citations, links)</p></li>
 <li><p>Be respectful in this community</p></li>
 </ul>
 </section>
-<section id="examples" class="level2" data-number="2.3">
-<h2 data-number="2.3" class="anchored" data-anchor-id="examples"><span class="header-section-number">2.3</span> Examples</h2>
+<section id="examples" class="level2" data-number="3.3">
+<h2 data-number="3.3" class="anchored" data-anchor-id="examples"><span class="header-section-number">3.3</span> Examples</h2>
 <p><u><strong>Example 1:</strong></u> The Open Source Initiative provides a <a href="https://opensource.org/osd/">definition</a>:</p>
 <ul>
 <li><p>Free distribution</p></li>
@@ -236,6 +247,7 @@ <h2 data-number="2.3" class="anchored" data-anchor-id="examples"><span class="he
 <p><u><strong>Example 2:</strong></u> <a href="#0" style="font-size: 11.4pt;">Merriam-Webster</a> defines open source as “having the source code freely available for possible modification and redistribution”.</p>
 
 
+</section>
 </section>
 
 </main> <!-- /main -->
@@ -480,7 +492,7 @@ <h2 data-number="2.3" class="anchored" data-anchor-id="examples"><span class="he
   </div>
   <div class="nav-page nav-page-next">
       <a href="./why.html" class="pagination-link">
-        <span class="nav-page-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span> <i class="bi bi-arrow-right-short"></i>
+        <span class="nav-page-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span> <i class="bi bi-arrow-right-short"></i>
       </a>
   </div>
 </nav>
diff --git a/trust.html b/trust.html
new file mode 100644
index 0000000..66b17d9
--- /dev/null
+++ b/trust.html
@@ -0,0 +1,488 @@
+<!DOCTYPE html>
+<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en"><head>
+
+<meta charset="utf-8">
+<meta name="generator" content="quarto-1.3.450">
+
+<meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=yes">
+
+
+<title>Open Source Technology in Clinical Data Analysis - 4&nbsp; Establishing Trust</title>
+<style>
+code{white-space: pre-wrap;}
+span.smallcaps{font-variant: small-caps;}
+div.columns{display: flex; gap: min(4vw, 1.5em);}
+div.column{flex: auto; overflow-x: auto;}
+div.hanging-indent{margin-left: 1.5em; text-indent: -1.5em;}
+ul.task-list{list-style: none;}
+ul.task-list li input[type="checkbox"] {
+  width: 0.8em;
+  margin: 0 0.8em 0.2em -1em; /* quarto-specific, see https://github.com/quarto-dev/quarto-cli/issues/4556 */ 
+  vertical-align: middle;
+}
+</style>
+
+
+<script src="site_libs/quarto-nav/quarto-nav.js"></script>
+<script src="site_libs/quarto-nav/headroom.min.js"></script>
+<script src="site_libs/clipboard/clipboard.min.js"></script>
+<script src="site_libs/quarto-search/autocomplete.umd.js"></script>
+<script src="site_libs/quarto-search/fuse.min.js"></script>
+<script src="site_libs/quarto-search/quarto-search.js"></script>
+<meta name="quarto:offset" content="./">
+<link href="./references.html" rel="next">
+<link href="./why.html" rel="prev">
+<script src="site_libs/quarto-html/quarto.js"></script>
+<script src="site_libs/quarto-html/popper.min.js"></script>
+<script src="site_libs/quarto-html/tippy.umd.min.js"></script>
+<script src="site_libs/quarto-html/anchor.min.js"></script>
+<link href="site_libs/quarto-html/tippy.css" rel="stylesheet">
+<link href="site_libs/quarto-html/quarto-syntax-highlighting.css" rel="stylesheet" id="quarto-text-highlighting-styles">
+<script src="site_libs/bootstrap/bootstrap.min.js"></script>
+<link href="site_libs/bootstrap/bootstrap-icons.css" rel="stylesheet">
+<link href="site_libs/bootstrap/bootstrap.min.css" rel="stylesheet" id="quarto-bootstrap" data-mode="light">
+<script id="quarto-search-options" type="application/json">{
+  "location": "sidebar",
+  "copy-button": false,
+  "collapse-after": 3,
+  "panel-placement": "start",
+  "type": "textbox",
+  "limit": 20,
+  "language": {
+    "search-no-results-text": "No results",
+    "search-matching-documents-text": "matching documents",
+    "search-copy-link-title": "Copy link to search",
+    "search-hide-matches-text": "Hide additional matches",
+    "search-more-match-text": "more match in this document",
+    "search-more-matches-text": "more matches in this document",
+    "search-clear-button-title": "Clear",
+    "search-detached-cancel-button-title": "Cancel",
+    "search-submit-button-title": "Submit",
+    "search-label": "Search"
+  }
+}</script>
+
+
+</head>
+
+<body class="nav-sidebar floating">
+
+<div id="quarto-search-results"></div>
+  <header id="quarto-header" class="headroom fixed-top">
+  <nav class="quarto-secondary-nav">
+    <div class="container-fluid d-flex">
+      <button type="button" class="quarto-btn-toggle btn" data-bs-toggle="collapse" data-bs-target="#quarto-sidebar,#quarto-sidebar-glass" aria-controls="quarto-sidebar" aria-expanded="false" aria-label="Toggle sidebar navigation" onclick="if (window.quartoToggleHeadroom) { window.quartoToggleHeadroom(); }">
+        <i class="bi bi-layout-text-sidebar-reverse"></i>
+      </button>
+      <nav class="quarto-page-breadcrumbs" aria-label="breadcrumb"><ol class="breadcrumb"><li class="breadcrumb-item"><a href="./trust.html"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></a></li></ol></nav>
+      <a class="flex-grow-1" role="button" data-bs-toggle="collapse" data-bs-target="#quarto-sidebar,#quarto-sidebar-glass" aria-controls="quarto-sidebar" aria-expanded="false" aria-label="Toggle sidebar navigation" onclick="if (window.quartoToggleHeadroom) { window.quartoToggleHeadroom(); }">      
+      </a>
+      <button type="button" class="btn quarto-search-button" aria-label="" onclick="window.quartoOpenSearch();">
+        <i class="bi bi-search"></i>
+      </button>
+    </div>
+  </nav>
+</header>
+<!-- content -->
+<div id="quarto-content" class="quarto-container page-columns page-rows-contents page-layout-article">
+<!-- sidebar -->
+  <nav id="quarto-sidebar" class="sidebar collapse collapse-horizontal sidebar-navigation floating overflow-auto">
+    <div class="pt-lg-2 mt-2 text-left sidebar-header sidebar-header-stacked">
+      <a href="./index.html" class="sidebar-logo-link">
+      <img src="./assets/phuse.png" alt="" class="sidebar-logo py-0 d-lg-inline d-none">
+      </a>
+    <div class="sidebar-title mb-0 py-0">
+      <a href="./">Open Source Technology in Clinical Data Analysis</a> 
+        <div class="sidebar-tools-main">
+    <div class="dropdown">
+      <a href="" title="Download" id="quarto-navigation-tool-dropdown-0" class="quarto-navigation-tool dropdown-toggle px-1" data-bs-toggle="dropdown" aria-expanded="false" aria-label="Download"><i class="bi bi-download"></i></a>
+      <ul class="dropdown-menu" aria-labelledby="quarto-navigation-tool-dropdown-0">
+          <li>
+            <a class="dropdown-item sidebar-tools-main-item" href="./Open-Source-Technology-in-Clinical-Data-Analysis.pdf">
+              <i class="bi bi-bi-file-pdf pe-1"></i>
+            Download PDF
+            </a>
+          </li>
+          <li>
+            <a class="dropdown-item sidebar-tools-main-item" href="./Open-Source-Technology-in-Clinical-Data-Analysis.docx">
+              <i class="bi bi-bi-file-word pe-1"></i>
+            Download Docx
+            </a>
+          </li>
+      </ul>
+    </div>
+    <div class="dropdown">
+      <a href="" title="Share" id="quarto-navigation-tool-dropdown-1" class="quarto-navigation-tool dropdown-toggle px-1" data-bs-toggle="dropdown" aria-expanded="false" aria-label="Share"><i class="bi bi-share"></i></a>
+      <ul class="dropdown-menu" aria-labelledby="quarto-navigation-tool-dropdown-1">
+          <li>
+            <a class="dropdown-item sidebar-tools-main-item" href="https://twitter.com/intent/tweet?url=|url|">
+              <i class="bi bi-bi-twitter pe-1"></i>
+            Twitter
+            </a>
+          </li>
+          <li>
+            <a class="dropdown-item sidebar-tools-main-item" href="https://www.facebook.com/sharer/sharer.php?u=|url|">
+              <i class="bi bi-bi-facebook pe-1"></i>
+            Facebook
+            </a>
+          </li>
+      </ul>
+    </div>
+</div>
+    </div>
+      </div>
+        <div class="mt-2 flex-shrink-0 align-items-center">
+        <div class="sidebar-search">
+        <div id="quarto-search" class="" title="Search"></div>
+        </div>
+        </div>
+    <div class="sidebar-menu-container"> 
+    <ul class="list-unstyled mt-1">
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./index.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text">Preface</span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./intro.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">1</span>&nbsp; <span class="chapter-title">OSTCDA</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./summary.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">2</span>&nbsp; <span class="chapter-title">What is Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./why.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link active">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./references.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text">References</span></a>
+  </div>
+</li>
+    </ul>
+    </div>
+</nav>
+<div id="quarto-sidebar-glass" data-bs-toggle="collapse" data-bs-target="#quarto-sidebar,#quarto-sidebar-glass"></div>
+<!-- margin-sidebar -->
+    <div id="quarto-margin-sidebar" class="sidebar margin-sidebar">
+        <nav id="TOC" role="doc-toc" class="toc-active">
+    <h2 id="toc-title">Table of contents</h2>
+   
+  <ul>
+  <li><a href="#can-an-open-source-solution-be-trusted" id="toc-can-an-open-source-solution-be-trusted" class="nav-link active" data-scroll-target="#can-an-open-source-solution-be-trusted"><span class="header-section-number">5</span> Can an open source solution be trusted?</a>
+  <ul class="collapse">
+  <li><a href="#contribute" id="toc-contribute" class="nav-link" data-scroll-target="#contribute"><span class="header-section-number">5.1</span> Contribute</a></li>
+  <li><a href="#guidance" id="toc-guidance" class="nav-link" data-scroll-target="#guidance"><span class="header-section-number">5.2</span> Guidance</a></li>
+  </ul></li>
+  </ul>
+</nav>
+    </div>
+<!-- main -->
+<main class="content" id="quarto-document-content">
+
+<header id="title-block-header" class="quarto-title-block default">
+<div class="quarto-title">
+<h1 class="title"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></h1>
+</div>
+
+
+
+<div class="quarto-title-meta">
+
+    
+  
+    
+  </div>
+  
+
+</header>
+
+<section id="can-an-open-source-solution-be-trusted" class="level1" data-number="5">
+<h1 data-number="5"><span class="header-section-number">5</span> Can an open source solution be trusted?</h1>
+<ul>
+<li><p>How do we have confidence that an open source solution is accurate?</p></li>
+<li><p>What are the relevant considerations?</p></li>
+</ul>
+<section id="contribute" class="level2" data-number="5.1">
+<h2 data-number="5.1" class="anchored" data-anchor-id="contribute"><span class="header-section-number">5.1</span> Contribute</h2>
+<p>Contribute to the discussion here:<br>
+<a href="https://github.com/phuse-org/OSTCDA/discussions/3">Can an open source solution be trusted to be accurate?</a></p>
+</section>
+<section id="guidance" class="level2" data-number="5.2">
+<h2 data-number="5.2" class="anchored" data-anchor-id="guidance"><span class="header-section-number">5.2</span> Guidance</h2>
+<ul>
+<li><p>Provide your thoughts and perspectives</p></li>
+<li><p>Provide references to articles, webinars, presentations (citations, links)</p></li>
+<li><p>Be respectful in this community</p></li>
+</ul>
+
+
+</section>
+</section>
+
+</main> <!-- /main -->
+<script id="quarto-html-after-body" type="application/javascript">
+window.document.addEventListener("DOMContentLoaded", function (event) {
+  const toggleBodyColorMode = (bsSheetEl) => {
+    const mode = bsSheetEl.getAttribute("data-mode");
+    const bodyEl = window.document.querySelector("body");
+    if (mode === "dark") {
+      bodyEl.classList.add("quarto-dark");
+      bodyEl.classList.remove("quarto-light");
+    } else {
+      bodyEl.classList.add("quarto-light");
+      bodyEl.classList.remove("quarto-dark");
+    }
+  }
+  const toggleBodyColorPrimary = () => {
+    const bsSheetEl = window.document.querySelector("link#quarto-bootstrap");
+    if (bsSheetEl) {
+      toggleBodyColorMode(bsSheetEl);
+    }
+  }
+  toggleBodyColorPrimary();  
+  const icon = "";
+  const anchorJS = new window.AnchorJS();
+  anchorJS.options = {
+    placement: 'right',
+    icon: icon
+  };
+  anchorJS.add('.anchored');
+  const isCodeAnnotation = (el) => {
+    for (const clz of el.classList) {
+      if (clz.startsWith('code-annotation-')) {                     
+        return true;
+      }
+    }
+    return false;
+  }
+  const clipboard = new window.ClipboardJS('.code-copy-button', {
+    text: function(trigger) {
+      const codeEl = trigger.previousElementSibling.cloneNode(true);
+      for (const childEl of codeEl.children) {
+        if (isCodeAnnotation(childEl)) {
+          childEl.remove();
+        }
+      }
+      return codeEl.innerText;
+    }
+  });
+  clipboard.on('success', function(e) {
+    // button target
+    const button = e.trigger;
+    // don't keep focus
+    button.blur();
+    // flash "checked"
+    button.classList.add('code-copy-button-checked');
+    var currentTitle = button.getAttribute("title");
+    button.setAttribute("title", "Copied!");
+    let tooltip;
+    if (window.bootstrap) {
+      button.setAttribute("data-bs-toggle", "tooltip");
+      button.setAttribute("data-bs-placement", "left");
+      button.setAttribute("data-bs-title", "Copied!");
+      tooltip = new bootstrap.Tooltip(button, 
+        { trigger: "manual", 
+          customClass: "code-copy-button-tooltip",
+          offset: [0, -8]});
+      tooltip.show();    
+    }
+    setTimeout(function() {
+      if (tooltip) {
+        tooltip.hide();
+        button.removeAttribute("data-bs-title");
+        button.removeAttribute("data-bs-toggle");
+        button.removeAttribute("data-bs-placement");
+      }
+      button.setAttribute("title", currentTitle);
+      button.classList.remove('code-copy-button-checked');
+    }, 1000);
+    // clear code selection
+    e.clearSelection();
+  });
+  function tippyHover(el, contentFn) {
+    const config = {
+      allowHTML: true,
+      content: contentFn,
+      maxWidth: 500,
+      delay: 100,
+      arrow: false,
+      appendTo: function(el) {
+          return el.parentElement;
+      },
+      interactive: true,
+      interactiveBorder: 10,
+      theme: 'quarto',
+      placement: 'bottom-start'
+    };
+    window.tippy(el, config); 
+  }
+  const noterefs = window.document.querySelectorAll('a[role="doc-noteref"]');
+  for (var i=0; i<noterefs.length; i++) {
+    const ref = noterefs[i];
+    tippyHover(ref, function() {
+      // use id or data attribute instead here
+      let href = ref.getAttribute('data-footnote-href') || ref.getAttribute('href');
+      try { href = new URL(href).hash; } catch {}
+      const id = href.replace(/^#\/?/, "");
+      const note = window.document.getElementById(id);
+      return note.innerHTML;
+    });
+  }
+      let selectedAnnoteEl;
+      const selectorForAnnotation = ( cell, annotation) => {
+        let cellAttr = 'data-code-cell="' + cell + '"';
+        let lineAttr = 'data-code-annotation="' +  annotation + '"';
+        const selector = 'span[' + cellAttr + '][' + lineAttr + ']';
+        return selector;
+      }
+      const selectCodeLines = (annoteEl) => {
+        const doc = window.document;
+        const targetCell = annoteEl.getAttribute("data-target-cell");
+        const targetAnnotation = annoteEl.getAttribute("data-target-annotation");
+        const annoteSpan = window.document.querySelector(selectorForAnnotation(targetCell, targetAnnotation));
+        const lines = annoteSpan.getAttribute("data-code-lines").split(",");
+        const lineIds = lines.map((line) => {
+          return targetCell + "-" + line;
+        })
+        let top = null;
+        let height = null;
+        let parent = null;
+        if (lineIds.length > 0) {
+            //compute the position of the single el (top and bottom and make a div)
+            const el = window.document.getElementById(lineIds[0]);
+            top = el.offsetTop;
+            height = el.offsetHeight;
+            parent = el.parentElement.parentElement;
+          if (lineIds.length > 1) {
+            const lastEl = window.document.getElementById(lineIds[lineIds.length - 1]);
+            const bottom = lastEl.offsetTop + lastEl.offsetHeight;
+            height = bottom - top;
+          }
+          if (top !== null && height !== null && parent !== null) {
+            // cook up a div (if necessary) and position it 
+            let div = window.document.getElementById("code-annotation-line-highlight");
+            if (div === null) {
+              div = window.document.createElement("div");
+              div.setAttribute("id", "code-annotation-line-highlight");
+              div.style.position = 'absolute';
+              parent.appendChild(div);
+            }
+            div.style.top = top - 2 + "px";
+            div.style.height = height + 4 + "px";
+            let gutterDiv = window.document.getElementById("code-annotation-line-highlight-gutter");
+            if (gutterDiv === null) {
+              gutterDiv = window.document.createElement("div");
+              gutterDiv.setAttribute("id", "code-annotation-line-highlight-gutter");
+              gutterDiv.style.position = 'absolute';
+              const codeCell = window.document.getElementById(targetCell);
+              const gutter = codeCell.querySelector('.code-annotation-gutter');
+              gutter.appendChild(gutterDiv);
+            }
+            gutterDiv.style.top = top - 2 + "px";
+            gutterDiv.style.height = height + 4 + "px";
+          }
+          selectedAnnoteEl = annoteEl;
+        }
+      };
+      const unselectCodeLines = () => {
+        const elementsIds = ["code-annotation-line-highlight", "code-annotation-line-highlight-gutter"];
+        elementsIds.forEach((elId) => {
+          const div = window.document.getElementById(elId);
+          if (div) {
+            div.remove();
+          }
+        });
+        selectedAnnoteEl = undefined;
+      };
+      // Attach click handler to the DT
+      const annoteDls = window.document.querySelectorAll('dt[data-target-cell]');
+      for (const annoteDlNode of annoteDls) {
+        annoteDlNode.addEventListener('click', (event) => {
+          const clickedEl = event.target;
+          if (clickedEl !== selectedAnnoteEl) {
+            unselectCodeLines();
+            const activeEl = window.document.querySelector('dt[data-target-cell].code-annotation-active');
+            if (activeEl) {
+              activeEl.classList.remove('code-annotation-active');
+            }
+            selectCodeLines(clickedEl);
+            clickedEl.classList.add('code-annotation-active');
+          } else {
+            // Unselect the line
+            unselectCodeLines();
+            clickedEl.classList.remove('code-annotation-active');
+          }
+        });
+      }
+  const findCites = (el) => {
+    const parentEl = el.parentElement;
+    if (parentEl) {
+      const cites = parentEl.dataset.cites;
+      if (cites) {
+        return {
+          el,
+          cites: cites.split(' ')
+        };
+      } else {
+        return findCites(el.parentElement)
+      }
+    } else {
+      return undefined;
+    }
+  };
+  var bibliorefs = window.document.querySelectorAll('a[role="doc-biblioref"]');
+  for (var i=0; i<bibliorefs.length; i++) {
+    const ref = bibliorefs[i];
+    const citeInfo = findCites(ref);
+    if (citeInfo) {
+      tippyHover(citeInfo.el, function() {
+        var popup = window.document.createElement('div');
+        citeInfo.cites.forEach(function(cite) {
+          var citeDiv = window.document.createElement('div');
+          citeDiv.classList.add('hanging-indent');
+          citeDiv.classList.add('csl-entry');
+          var biblioDiv = window.document.getElementById('ref-' + cite);
+          if (biblioDiv) {
+            citeDiv.innerHTML = biblioDiv.innerHTML;
+          }
+          popup.appendChild(citeDiv);
+        });
+        return popup.innerHTML;
+      });
+    }
+  }
+});
+</script>
+<nav class="page-navigation">
+  <div class="nav-page nav-page-previous">
+      <a href="./why.html" class="pagination-link">
+        <i class="bi bi-arrow-left-short"></i> <span class="nav-page-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span>
+      </a>          
+  </div>
+  <div class="nav-page nav-page-next">
+      <a href="./references.html" class="pagination-link">
+        <span class="nav-page-text">References</span> <i class="bi bi-arrow-right-short"></i>
+      </a>
+  </div>
+</nav>
+</div> <!-- /content -->
+
+
+
+</body></html>
\ No newline at end of file
diff --git a/why.html b/why.html
index e90f009..24e115b 100644
--- a/why.html
+++ b/why.html
@@ -7,7 +7,7 @@
 <meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=yes">
 
 
-<title>Open Source Technology in Clinical Data Analysis - 3&nbsp; What is the ‘why’ for using open source solutions in pharma clinical data analytics?</title>
+<title>Open Source Technology in Clinical Data Analysis - 3&nbsp; Why Open Source?</title>
 <style>
 code{white-space: pre-wrap;}
 span.smallcaps{font-variant: small-caps;}
@@ -30,7 +30,7 @@
 <script src="site_libs/quarto-search/fuse.min.js"></script>
 <script src="site_libs/quarto-search/quarto-search.js"></script>
 <meta name="quarto:offset" content="./">
-<link href="./references.html" rel="next">
+<link href="./trust.html" rel="next">
 <link href="./summary.html" rel="prev">
 <script src="site_libs/quarto-html/quarto.js"></script>
 <script src="site_libs/quarto-html/popper.min.js"></script>
@@ -74,7 +74,7 @@
       <button type="button" class="quarto-btn-toggle btn" data-bs-toggle="collapse" data-bs-target="#quarto-sidebar,#quarto-sidebar-glass" aria-controls="quarto-sidebar" aria-expanded="false" aria-label="Toggle sidebar navigation" onclick="if (window.quartoToggleHeadroom) { window.quartoToggleHeadroom(); }">
         <i class="bi bi-layout-text-sidebar-reverse"></i>
       </button>
-      <nav class="quarto-page-breadcrumbs" aria-label="breadcrumb"><ol class="breadcrumb"><li class="breadcrumb-item"><a href="./why.html"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the 'why' for using open source solutions in pharma clinical data analytics?</span></a></li></ol></nav>
+      <nav class="quarto-page-breadcrumbs" aria-label="breadcrumb"><ol class="breadcrumb"><li class="breadcrumb-item"><a href="./why.html"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></a></li></ol></nav>
       <a class="flex-grow-1" role="button" data-bs-toggle="collapse" data-bs-target="#quarto-sidebar,#quarto-sidebar-glass" aria-controls="quarto-sidebar" aria-expanded="false" aria-label="Toggle sidebar navigation" onclick="if (window.quartoToggleHeadroom) { window.quartoToggleHeadroom(); }">      
       </a>
       <button type="button" class="btn quarto-search-button" aria-label="" onclick="window.quartoOpenSearch();">
@@ -159,7 +159,13 @@
         <li class="sidebar-item">
   <div class="sidebar-item-container"> 
   <a href="./why.html" class="sidebar-item-text sidebar-link active">
- <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></span></a>
+ <span class="menu-text"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></span></a>
+  </div>
+</li>
+        <li class="sidebar-item">
+  <div class="sidebar-item-container"> 
+  <a href="./trust.html" class="sidebar-item-text sidebar-link">
+ <span class="menu-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span></a>
   </div>
 </li>
         <li class="sidebar-item">
@@ -178,8 +184,11 @@
     <h2 id="toc-title">Table of contents</h2>
    
   <ul>
-  <li><a href="#contribute" id="toc-contribute" class="nav-link active" data-scroll-target="#contribute"><span class="header-section-number">3.1</span> Contribute</a></li>
-  <li><a href="#guidance" id="toc-guidance" class="nav-link" data-scroll-target="#guidance"><span class="header-section-number">3.2</span> Guidance</a></li>
+  <li><a href="#what-is-the-why-for-using-open-source-solutions-in-pharma-clinical-data-analytics" id="toc-what-is-the-why-for-using-open-source-solutions-in-pharma-clinical-data-analytics" class="nav-link active" data-scroll-target="#what-is-the-why-for-using-open-source-solutions-in-pharma-clinical-data-analytics"><span class="header-section-number">4</span> What is the ‘why’ for using open source solutions in pharma clinical data analytics?</a>
+  <ul class="collapse">
+  <li><a href="#contribute" id="toc-contribute" class="nav-link" data-scroll-target="#contribute"><span class="header-section-number">4.1</span> Contribute</a></li>
+  <li><a href="#guidance" id="toc-guidance" class="nav-link" data-scroll-target="#guidance"><span class="header-section-number">4.2</span> Guidance</a></li>
+  </ul></li>
   </ul>
 </nav>
     </div>
@@ -188,7 +197,7 @@ <h2 id="toc-title">Table of contents</h2>
 
 <header id="title-block-header" class="quarto-title-block default">
 <div class="quarto-title">
-<h1 class="title"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">What is the ‘why’ for using open source solutions in pharma clinical data analytics?</span></h1>
+<h1 class="title"><span class="chapter-number">3</span>&nbsp; <span class="chapter-title">Why Open Source?</span></h1>
 </div>
 
 
@@ -203,18 +212,20 @@ <h1 class="title"><span class="chapter-number">3</span>&nbsp; <span class="chapt
 
 </header>
 
+<section id="what-is-the-why-for-using-open-source-solutions-in-pharma-clinical-data-analytics" class="level1" data-number="4">
+<h1 data-number="4"><span class="header-section-number">4</span> What is the ‘why’ for using open source solutions in pharma clinical data analytics?</h1>
 <ul>
 <li><p>What is the attraction to open source solutions?</p></li>
 <li><p>Why do users like open source solutions?</p></li>
 <li><p>Why are leaders of organizations in Data Management, Biostatistics, and Programming devoting resources toward the development, testing, and adoption of open source solutions?</p></li>
 </ul>
-<section id="contribute" class="level2" data-number="3.1">
-<h2 data-number="3.1" class="anchored" data-anchor-id="contribute"><span class="header-section-number">3.1</span> Contribute</h2>
+<section id="contribute" class="level2" data-number="4.1">
+<h2 data-number="4.1" class="anchored" data-anchor-id="contribute"><span class="header-section-number">4.1</span> Contribute</h2>
 <p>Contribute to the discussion here:<br>
-<a href="https://github.com/phuse-org/OSTCDA/discussions/2">What is they ‘why’ for open source?</a></p>
+<a href="https://github.com/phuse-org/OSTCDA/discussions/2">What is the ‘why’ for open source?</a></p>
 </section>
-<section id="guidance" class="level2" data-number="3.2">
-<h2 data-number="3.2" class="anchored" data-anchor-id="guidance"><span class="header-section-number">3.2</span> Guidance</h2>
+<section id="guidance" class="level2" data-number="4.2">
+<h2 data-number="4.2" class="anchored" data-anchor-id="guidance"><span class="header-section-number">4.2</span> Guidance</h2>
 <ul>
 <li><p>Provide your thoughts and perspectives</p></li>
 <li><p>Provide references to articles, webinars, presentations (citations, links)</p></li>
@@ -222,6 +233,7 @@ <h2 data-number="3.2" class="anchored" data-anchor-id="guidance"><span class="he
 </ul>
 
 
+</section>
 </section>
 
 </main> <!-- /main -->
@@ -465,8 +477,8 @@ <h2 data-number="3.2" class="anchored" data-anchor-id="guidance"><span class="he
       </a>          
   </div>
   <div class="nav-page nav-page-next">
-      <a href="./references.html" class="pagination-link">
-        <span class="nav-page-text">References</span> <i class="bi bi-arrow-right-short"></i>
+      <a href="./trust.html" class="pagination-link">
+        <span class="nav-page-text"><span class="chapter-number">4</span>&nbsp; <span class="chapter-title">Establishing Trust</span></span> <i class="bi bi-arrow-right-short"></i>
       </a>
   </div>
 </nav>