Internal Validity: Definition and threats

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Questions and Answers

Which of the following best describes internal validity in research?

  • The subjective assessment of the participants' experiences in a study.
  • The consistency and stability of the measurement instrument used in a study.
  • The extent to which the results of a study can be generalized to other populations and settings.
  • The degree to which a study accurately demonstrates a cause-and-effect relationship between variables. (correct)

Which of the following scenarios best illustrates ambiguous temporal precedence?

  • A study finds that increased exercise is correlated with improved mood, but it is unclear if exercise causes better mood or if people with better moods are more likely to exercise. (correct)
  • A researcher modifies a survey questionnaire midway through a study, leading to inconsistent data.
  • Participants in a weight loss program lose weight, but it is unclear if the weight loss is due to the program or changes in their diet.
  • A study observes a decrease in crime rates after a new community policing initiative is implemented.

How does the threat of 'history' affect the internal validity of a study?

  • It involves changes in the measurement instrument used over time.
  • It changes the way participants respond due to repeated testing.
  • It introduces systematic differences between groups being compared.
  • It refers to external events occurring during the study that could influence the outcome. (correct)

In a study evaluating a weight loss program, participants naturally lose some weight over time simply due to the body's own processes. Which threat to internal validity does this best exemplify?

<p>Maturation (C)</p> Signup and view all the answers

A clinic recruits patients with extremely high blood pressure to test a new medication. After several weeks, their blood pressure readings decrease, but some of this decrease may be due to ____.

<p>regression to the mean (C)</p> Signup and view all the answers

How can taking a pre-test influence participants' responses on a post-test?

<p>By making participants more aware of the issue being measured (D)</p> Signup and view all the answers

Which of the following scenarios illustrates the threat of 'instrumentation'?

<p>A blood pressure cuff used in a study is not calibrated correctly, leading to inaccurate readings. (A)</p> Signup and view all the answers

Why is selection bias a threat to internal validity?

<p>It can introduce systematic differences between groups being compared. (A)</p> Signup and view all the answers

Randomization is a method used to minimize which threat to internal validity?

<p>Selection bias (C)</p> Signup and view all the answers

What is the primary difference between internal and external validity?

<p>Internal validity refers to the cause-and-effect relationship within the study, while external validity refers to the generalizability of the findings. (B)</p> Signup and view all the answers

If researchers find that the order in which variables are presented impacts a study's outcome, which threat to internal validity would this best exemplify?

<p>Ambiguous temporal precedence (D)</p> Signup and view all the answers

Which of the following is NOT a strategy to mitigate the threat of testing in a study?

<p>Using a pre-test/post-test design (D)</p> Signup and view all the answers

In a long-term study, what is the primary concern regarding the measuring instrument to ensure internal validity?

<p>Ensuring the instrument maintains precision throughout the observation period. (B)</p> Signup and view all the answers

Why are Randomized Controlled Trials (RCTs) considered higher in the hierarchy of evidence?

<p>They are presumably associated with fewer threats to internal validity. (B)</p> Signup and view all the answers

Which of the following study designs is most susceptible to selection bias?

<p>Case-control study (D)</p> Signup and view all the answers

What is the role of a concurrent control group in mitigating threats to internal validity?

<p>To account for external events that might affect outcomes. (C)</p> Signup and view all the answers

If a study finds that participants in an intervention group improved primarily because they were more enthusiastic about the study than the control group, this could be an example of:

<p>Selection by maturation (B)</p> Signup and view all the answers

Why is it essential to consider threats to internal validity, even in RCTs?

<p>Because no study design is immune to all threats. (D)</p> Signup and view all the answers

A researcher modifies a study to ensure that any external events affect both the intervention and control groups equally. Which threat to internal validity is he primarily trying to control?

<p>History (A)</p> Signup and view all the answers

Which of the following is the MOST effective way to address selection bias in a study?

<p>Randomly assigning participants to groups (D)</p> Signup and view all the answers

A town implements a new traffic light program to reduce accidents. After 6 months, accident rates decrease. However, during the same period, several public service announcements about safe driving were released. Which threat to internal validity is MOST likely affecting this evaluation?

<p>History (A)</p> Signup and view all the answers

A therapist assesses patients with social anxiety, and selects those with the highest anxiety scores to participate in a new therapy program. What validity threat is MOST likely influencing the results?

<p>Regression to the mean (A)</p> Signup and view all the answers

A researcher uses the same cognitive test before and after an intervention to assess the impact of a new memory-enhancing drug. Participants performed better on the second test simply due to practice. Which threat to internal validity is this an example of?

<p>Testing (D)</p> Signup and view all the answers

A researcher evaluates the effectiveness of a new survey designed to measure job satisfaction over a 5-year period. Early in the study, the survey was administered on paper, but later it was switched to an online format. Which potential threat to internal validity does this change MOST directly introduce?

<p>Instrumentation (D)</p> Signup and view all the answers

A study compares the effectiveness of a new drug to standard therapy, one group consists of patients who actively sought out participation, while the other received standard care from their regular doctor, which threat to internal validity is MOST apparent?

<p>Selection bias (B)</p> Signup and view all the answers

A researcher is studying the impact of a new educational program on student test scores. The study begins in January, but in February the local school district changes its curriculum. This situation poses a threat to internal validity primarily because of which factor?

<p>An external event is influencing the outcome. (C)</p> Signup and view all the answers

In a study assessing the long-term impact of a weight-loss program, some participants start exercising more regularly on their own, independent of the program. This scenario illustrates a potential threat to internal validity due to:

<p>Maturation (A)</p> Signup and view all the answers

A group of students who scored very low on a pre-test participate in a tutoring program, the program evaluation shows improved post-test scores. Which threat poses the GREATEST concern for the study’s validity?

<p>Regression to the mean (A)</p> Signup and view all the answers

A researcher finds that participants' performance on a post-test improves because they remember the questions from the pre-test. Which of the following strategies would be MOST effective in addressing this threat?

<p>Using different versions of the test for the pre and posttests. (D)</p> Signup and view all the answers

A study's survey questions are altered midway through the data collection process in order to capture more relevant insights. This introduces which threat to internal validity?

<p>Instrumentation (B)</p> Signup and view all the answers

A researcher compares satisfaction of elderly patients, one group is recruited from an assisted living facility, and another is living independently at home. What threat to internal validity is MOST directly related to the differences between these groups?

<p>Selection bias (B)</p> Signup and view all the answers

A training initiative takes place at the same time that an organization makes widespread changes to its operational processes. It becomes difficult to say whether improvements are due to the training or to the changes in operational processes, making it a:

<p>History threat (B)</p> Signup and view all the answers

A researcher examines the impact of a year-long exercise regimen on overall fitness from January to December; what is the MOST relevant threat to validity given the time scale and nature of this intervention?

<p>Natural changes to people over time (D)</p> Signup and view all the answers

When might participants be selected or volunteer because they have much higher or lower scores than the true average for the outcome variable?

<p>When there is concern about regression to the mean. (C)</p> Signup and view all the answers

In a study, subjects are exposed to the same or similar stimuli before the actual experiment which leads to an underestimation of the true effect of the independent variable (cause). What type of effect is happening?

<p>Habituation (D)</p> Signup and view all the answers

A researcher is evaluating whether smoking causes a higher risk of lung cancer. What term best fits the definition of cause comes before the effect?

<p>Temporality according to Bradford Hill (C)</p> Signup and view all the answers

Why is understanding threats to internal validity crucial when evaluating research?

<p>It enables identification of methodological problems that impact the reliability of a study's conclusions. (C)</p> Signup and view all the answers

What is the primary focus of internal validity in research?

<p>Determining the accuracy of cause-and-effect relationships within the study. (C)</p> Signup and view all the answers

In a study examining the effect of a new exercise program on weight loss, participants are weighed at the beginning and end of the program. What is the MOST relevant threat to internal validity given the time scale and nature of this intervention?

<p>Maturation (B)</p> Signup and view all the answers

What BEST describes ambiguous temporal precedence?

<p>It is unclear whether the presumed cause preceded the effect, making causal inference difficult. (D)</p> Signup and view all the answers

A researcher is evaluating a new educational program on mathematics scores. Midway through the study, a well-publicized national news story is released highlighting the importance of mathematics. This situation poses a threat to internal validity primarily because of which factor?

<p>History (B)</p> Signup and view all the answers

In the context of internal validity, what BEST describes the threat of 'maturation'?

<p>Natural changes occurring in participants over time. (B)</p> Signup and view all the answers

How does the inclusion of a concurrent control group mitigate the threat of maturation in a study?

<p>By accounting for natural changes that occur similarly in both groups. (B)</p> Signup and view all the answers

Which of the following is the BEST example of regression to the mean?

<p>A patient's blood pressure returns to average after being extremely high. (C)</p> Signup and view all the answers

A school selects students with the lowest scores to participate in a new reading intervention program. Following the program, their scores improve. What threat to internal validity is MOST likely influencing the results?

<p>Regression to the mean (B)</p> Signup and view all the answers

What is the primary concern regarding 'testing' as a threat to internal validity?

<p>The influence of a pre-test on post-test performance. (B)</p> Signup and view all the answers

In what way can 'habituation' affect the results of a study?

<p>By leading to an underestimation of the true effect of the independent variable. (D)</p> Signup and view all the answers

In a study, subjects are exposed to similar stimuli before the actual experiment. What type of effect is happening?

<p>Habituation (C)</p> Signup and view all the answers

How does 'instrumentation' pose a threat to internal validity?

<p>Through changes in the measuring instrument or its application over time. (A)</p> Signup and view all the answers

What differentiates instrumentation from testing?

<p>Instrumentation involves changes in the measuring device while testing involves changes in the participant. (A)</p> Signup and view all the answers

What role does randomization play in minimizing selection bias?

<p>It makes systematic differences in patient characteristics between groups highly unlikely. (C)</p> Signup and view all the answers

Selection bias is particularly problematic for what type of study designs?

<p>Observational study designs. (B)</p> Signup and view all the answers

Why are Randomized Controlled Trials (RCTs) considered higher in the hierarchy of evidence in comparison to observational studies?

<p>They tend to be associated with fewer threats to internal validity. (B)</p> Signup and view all the answers

A concurrent control group is used to control for what threat to internal validity??

<p>History (B)</p> Signup and view all the answers

Threats to internal validity are MOST important to consider under what circumstances?

<p>When analyzing research for biases, strengths and weaknesses in its design. (C)</p> Signup and view all the answers

Flashcards

Internal Validity

The extent to which a study accurately measures the cause-and-effect relationship, ensuring results are not due to chance or other factors.

Ambiguous Temporal Precedence

Uncertainty about which variable came first, making it difficult to establish causality.

History (Threat to Validity)

External events occurring during the study that might affect the outcome, providing an alternative explanation to the exposure.

Maturation (Threat to Validity)

Natural changes occurring over time that might influence the outcome, irrespective of the intervention.

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Regression to the Mean

The tendency for extreme scores to regress toward the mean upon retesting.

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Testing Effects

When taking a pre-test influences participant responses on the post-test.

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Instrumentation (Threat to Validity)

Changes in the measuring instrument or its use over time that might affect the results.

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Selection Bias

Systematic differences in participant characteristics between groups at the start of the study.

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Sensitization

Being more aware of the intention of the study after taking the pre-test can influence the outcome of the study

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Habituation

A form of learning where a repeated stimulus becomes less effective in eliciting a response over time.

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Study Notes

Internal Validity: The Overarching Term

  • Internal validity is crucial for determining the impact of a study on clinical practice.
  • Threats to internal validity are evident based on study design and can significantly affect what can be learned from a study.
  • Understanding these threats helps identify problems in a study's methodology, discard unreliable evidence, and identify quality studies.
  • Understanding these threats will lead to greater confidence in the author's conclusions.

Defining Validity and Internal Validity

  • Validity, according to "Merriam-Webster", is "The quality of being well grounded sound and correct".
  • For this course, the key term in the definition of validity is correctness.
  • Validity of experience refers to the genuineness and authenticity of an individual's personal experience.
  • Validity of arguments requires logical soundness, evidence, consideration of different perspectives, and avoidance of logical fallacies.
  • Validity of assessments accurately measures what it is intended to measure, free from bias.
  • Validity of emotions acknowledges that emotions are real and meaningful for the individual.
  • Internal validity focuses on evaluating evidence in the literature.
  • Internal validity is "The extent to which the methodological research design used by a researcher can provide empirical evidence to test the possible cause and effect relationship".
  • Internal validity indicates how confident one can be that the results of a study are not due to chance or other factors besides the one being investigated.
  • Researchers must be aware of threats to internal validity, such as selection bias and confounding variables, and take steps to mitigate them.
  • A study can have high internal validity even if it is not generalizable to a wider population (external validity).
  • Low internal validity makes a study essentially useless.

Threats to Internal Validity

  • They help determine if there might be alternative explanations for a cause and effect relationship.
  • These threats must be considered within the context of how a researcher designed a specific study.
  • It is vital to keep all these terms in mind when reading certain types of research studies.

Ambiguous Temporal Precedence

  • Ambiguous Temporal Precedence refers to uncertainty about which variable came first, making it difficult to draw causal conclusions.
  • A cause must precede the effect (temporality).
  • This ambiguity can weaken the conclusions drawn from a study.
  • New Fertilizer and Plant Growth example: It was unclear if the increased growth was due to the fertilizer, the warmer weather, or both independently.
  • Pre-testing participants, using randomized controlled trials, and employing statistical techniques can mitigate ambiguous temporal precedence.
  • Cross-Sectional Study on Media Use and Wellbeing example: It's impossible to establish whether SBM use leads to less happiness, or whether less happiness leads to more SBM use.

History

  • History refers to external events that occur during a study that may affect the outcome rather than the exposure.
  • Antibiotic Effect on Bacteria example: A power outage affected the outcome rather than the antibiotic.
  • Opioid Prescription Policy Evaluation example: The observed effect might not be due to policy A implemented in 2013 but to other events.

Maturation

  • Maturation refers to natural changes that occur over time, where effects may be due to these changes rather than the intervention.
  • Maturation includes things like aging and gaining experience.
  • Ginger Root Extract for the Common Cold example: Any improvement might be due to the natural progression of the cold (maturation) rather than the supplement.
  • Maturation can be addressed by having a control group or comparison group running concurrently with the treated group.

Regression to the Mean

  • Regression to the mean: Subjects selected based on extreme scores tend to have subsequent scores move toward the average.
  • Psychotherapy Patients example: Improvement could be due to spontaneous remission rather than therapy.
  • Business Consultants example: Improvement could be due to a natural cycle rather than the consultant's actions.

Testing

  • Testing: The act of taking a pre-test can influence post-test responses.
  • Sensitization: Participants become more aware of the issue being measured.
  • Habituation: Repeated stimulus becomes less effective.
  • Response fatigue: Repeated exposure causes fatigue or boredom.
  • New Teaching Method example: Improved post-test performance is due to familiarity rather than the new method.
  • Utilize different pre-test and post-test measures or introduce a delay between tests to mitigate testing effects.

Instrumentation

  • Instrumentation: Changes to the measuring instrument itself over the study period (instrument changes not participant changes).
  • Survey and patient interview examples of instruments.
  • Changes in surveys or observer precision can lead to effects that reflect the instrument change, not the exposure.

Selection Bias

  • Selection bias: Systematic differences in patient characteristics at baseline between groups.
  • Comparing an experimental anti-infective agent to a control group where the control group is older on average than the treatment group is an example of selection bias.
  • Randomization can eliminate selection bias.

Conclusion: Applying Knowledge of Internal Validity Threats

  • Internal threats become more evident based on study design.
  • Consider these potential threats and whether they are real threats given the study's design.
  • RCTs have fewer threats to internal validity compared to observational research designs.
  • Research design (e.g., control group) and methods (e.g., randomization) help minimize threats to internal validity.
  • Internal validity focuses on the cause and effect relationship within the study itself.
  • Threats to internal validity are crucial when discussing biases, strengths, and weaknesses of study designs.

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