scholarly journals Using the RE-AIM framework to evaluate internal and external validity of mobile phone–based interventions in diabetes self-management education and support

2020 ◽  
Vol 27 (6) ◽  
pp. 946-956 ◽  
Author(s):  
Yilin Yoshida ◽  
Sonal J Patil ◽  
Ross C Brownson ◽  
Suzanne A Boren ◽  
Min Kim ◽  
...  
Keyword(s):  
External Validity ◽  
Management Education ◽  
Data Extraction ◽  
Internal Validity ◽  
Self Management ◽  
Future Research ◽  
Limited Information ◽  
Quality Of Reporting ◽  
Screening Process ◽  
Internal And External Validity

Abstract Objective We evaluated the extent to which studies that tested short message service (SMS)– and application (app)-based interventions for diabetes self-management education and support (DSMES) report on factors that inform both internal and external validity as measured by the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework. Materials and Methods We systematically searched PubMed, Embase, Web of Science, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and IEEE Xplore Digital Library for articles from January 1, 2009, to February 28, 2019. We carried out a multistage screening process followed by email communications with study authors for missing or discrepant information. Two independent coders coded eligible articles using a 23-item validated data extraction tool based on the RE-AIM framework. Results Twenty studies (21 articles) were included in the analysis. The comprehensiveness of reporting on the RE-AIM criteria across the SMS- and app-based DSMES studies was low. With respect to internal validity, most interventions were well described and primary clinical or behavioral outcomes were measured and reported. However, gaps exist in areas of attrition, measures of potential negative outcomes, the extent to which the protocol was delivered as intended, and description on delivery agents. Likewise, we found limited information on external validity indicators across adoption, implementation, and maintenance domains. Conclusions Reporting gaps were found in internal validity but more so in external validity in the current SMS- and app-based DSMES literature. Because most studies in this review were efficacy studies, the generalizability of these interventions cannot be determined. Future research should adopt the RE-AIM dimensions to improve the quality of reporting and enhance the likelihood of translating research to practice.

scholarly journals A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Samina Ali ◽  
◽  
Gareth Hopkin ◽  
Naveen Poonai ◽  
Lawrence Richer ◽  
...  
Keyword(s):  
External Validity ◽  
Treatment Options ◽  
Internal Validity ◽  
Clinical Effectiveness ◽  
Drop Out ◽  
Innovative Design ◽  
Clinical Trial Research ◽  
Research Questions ◽  
Internal And External Validity ◽  
Treatment Population

Abstract Background Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences.

scholarly journals High Fidelity Microsurgical Simulation: The Thiel Model and Evaluation Instrument

2018 ◽  
Vol 27 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Andrei Odobescu ◽  
Isak Goodwin ◽  
Djamal Berbiche ◽  
Joseph BouMerhi ◽  
Patrick G. Harris ◽  
...  
Keyword(s):  
External Validity ◽  
Internal Validity ◽  
High Fidelity ◽  
Evaluation Instrument ◽  
Intra Class Correlation ◽  
Validity Measures ◽  
The Difference ◽  
Fidelity Model ◽  
Junior Residents ◽  
Internal And External Validity

Background: The Thiel embalmment method has recently been used in a number of medical simulation fields. The authors investigate the use of Thiel vessels as a high fidelity model for microvascular simulation and propose a new checklist-based evaluation instrument for microsurgical training. Methods: Thirteen residents and 2 attending microsurgeons performed video recorded microvascular anastomoses on Thiel embalmed arteries that were evaluated using a new evaluation instrument (Microvascular Evaluation Scale) by 4 fellowship trained microsurgeons. The internal validity was assessed using the Cronbach coefficient. The external validity was verified using regression models. Results: The reliability assessment revealed an excellent intra-class correlation of 0.89. When comparing scores obtained by participants from different levels of training, attending surgeons and senior residents (Post Graduate Year [PGY] 4-5) scored significantly better than junior residents (PGY 1-3). The difference between senior residents and attending surgeons was not significant. When considering microsurgical experience, the differences were significant between the advanced group and the minimal and moderate experience groups. The differences between minimal and moderate experience groups were not significant. Based on the data obtained, a score of 8 would translate into a level of microsurgical competence appropriate for clinical microsurgery. Conclusions: Thiel cadaveric vessels are a high fidelity model for microsurgical simulation. Excellent internal and external validity measures were obtained using the Microvascular Evaluation Scale (MVES).

scholarly journals Adding Focused Life Skills Training to a Civic Engagement Program to Boost Life Skills Competencies in Youth

2016 ◽  
Vol 11 (2) ◽  
Author(s):  
Brian Brandt ◽  
Jan Klein
Keyword(s):  
Civic Engagement ◽  
Civic Education ◽  
External Validity ◽  
Life Skills ◽  
Skills Training ◽  
Future Research ◽  
Education Curriculum ◽  
Life Skills Training ◽  
Training Content ◽  
Internal And External Validity

This paper highlights the impacts of a revised curriculum which incorporated a strong life skills focus into an existing civic education curriculum (for 4-H youth). The revised curriculum resulted in actual youth gains in life skills competencies. The study also explored the effect of volunteer facilitators in the implementation of an added life skills training component. Despite some significant limitations to the internal and external validity of the study, preliminary indications were that adding explicit life skills training content does in fact lead to an increase in life skills competencies. This was clearer in cases where volunteer facilitators fully implemented the additional content versus implementing none or only part of the life skills training. The limitations of the study and suggestions for future research are outlined in the conclusion.

scholarly journals 1044 Adequate Sleep is Associated with Improved Diabetes Knowledge and HbA1c

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A396-A397
Author(s):  
A Pandey ◽  
L Cooper ◽  
J Zrebiec ◽  
C Spadola ◽  
R L Bennett ◽  
...  
Keyword(s):  
Management Education ◽  
Diabetes Education ◽  
Sleep Hygiene ◽  
Self Report ◽  
Self Management ◽  
Future Research ◽  
Diabetes Knowledge ◽  
Emotional Wellbeing ◽  
Motivation For Change ◽  
The Relationship

Abstract Introduction Although 55 % of the people with T2DM have low quality of sleep that may affect their physical and emotional wellbeing, and present challenges to the management of their condition, many Diabetes Self-Management Education Programs (DSME) that aim to improve knowledge of T2DM, don’t include information on healthy sleep. This study will examine the relationship between adequate sleep on improved T2DM knowledge and diabetes maintenance (HbA1c). Methods The Sleep Integrated with Diabetes Education (SLIDE) Trial tests whether including four brief healthy sleep hygiene sessions within an existing traditional Diabetes Self-Management Education Program improves healthy sleep, motivation for change, and biopsychosocial outcomes for 50 patients with DM who are under and uninsured. This study uses descriptive and ANOVAs to examine the relationship between adequate sleep and change in diabetes knowledge (Diabetes Knowledge Test) using self-report. EMR was used to link HbA1c and other biological measures. Results Fifty patients with T2DM (mean HbA1c = 8.79 ± 2.42) participating in a DSME Program at a southern urban community nonprofit hospital were randomly assigned to DSME classes or DSME classes + four 15-minute presentations (video and powerpoint) highlighting healthy sleep hygiene practices. The majority of these patients were obese (mean BMI=38.56±8.20). Only 11% reported normal sleep, with 41% reporting short sleep (<6 hours) and 7% long sleep (>8 hours). Patients who reported adequate sleep were more likely to improve diabetes knowledge (81% score vs. 68% score, p<.001) and HbA1c (1.1 vs. -.03, p<.001). Conclusion There is a relationship between adequate sleep and improving diabetes knowledge and maintenance for patients with T2DM. Future research could further explore this relationship and determine barriers and facilitators to adequate sleep and what role adequate sleep plays in improving T2DM knowledge and maintenance. Support Bon Sequor Foundation

Internal and External Validity in Ethical Reasoning

2021 ◽  
pp. 40-61
Author(s):  
James Wilson
Keyword(s):  
Real World ◽  
External Validity ◽  
Thought Experiment ◽  
Ethical Reasoning ◽  
Internal Validity ◽  
Thought Experiments ◽  
American Philosophy ◽  
Anglo American ◽  
Internal And External Validity ◽  
Rigorous Method

A particular approach to ethical reasoning has come to dominate much Anglo-American philosophy, one which assumes that the most rigorous method is to proceed by analysis of thought experiments. In thought experiments, features such as context and history are stripped away, and all factors other than those of ethical interest are stipulated to be equal. This chapter argues that even if a thought experiment produces results that are internally valid—in that it provides a genuine ethical insight about the highly controlled and simplified experimental scenario under discussion—this does not imply external validity. Just as in empirical experiments, there is a yawning gap between succeeding in the relatively easy project of establishing internal validity in a controlled and simplified context, and the more difficult one of establishing external validity in the messier and more complex real world.

The internal and external validity of the Major Depression Inventory in measuring severity of depressive states

2003 ◽  
Vol 33 (2) ◽  
pp. 351-356 ◽  
Author(s):  
L. R. OLSEN ◽  
D. V. JENSEN ◽  
V. NOERHOLM ◽  
K. MARTINY ◽  
P. BECH
Keyword(s):  
Major Depression ◽  
External Validity ◽  
Depression Scale ◽  
Internal Validity ◽  
Depressive Illness ◽  
Hamilton Depression Scale ◽  
Major Depression Inventory ◽  
Icd 10 ◽  
Internal And External Validity ◽  
Depressive States

Background. We have developed the Major Depression Inventory (MDI), consisting of 10 items, covering the DSM-IV as well as the ICD-10 symptoms of depressive illness. We aimed to evaluate this as a scale measuring severity of depressive states with reference to both internal and external validity.Method. Patients representing the score range from no depression to marked depression on the Hamilton Depression Scale (HAM-D) completed the MDI. Both classical and modern psychometric methods were applied for the evaluation of validity, including the Rasch analysis.Results. In total, 91 patients were included. The results showed that the MDI had an adequate internal validity in being a unidimensional scale (the total score an appropriate or sufficient statistic). The external validity of the MDI was also confirmed as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0·86, P[les ]0·01, Spearman 0·80, P[les ]0·01).Conclusion. When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

scholarly journals Experimental and Non-Experimental Methods in Development Economics: A Porous Dialectic

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Rajeev Dehejia
Keyword(s):  
Randomized Controlled Trials ◽  
External Validity ◽  
Internal Validity ◽  
Experimental Methods ◽  
Controlled Trials ◽  
Data Sets ◽  
Randomized Controlled ◽  
Nationally Representative ◽  
High Degree ◽  
Internal And External Validity

AbstractThis paper surveys six widely-used non-experimental methods for estimating treatment effects (instrumental variables, regression discontinuity, direct matching, propensity score matching, linear regression and non-parametric methods, and difference-in-differences), and assesses their internal and external validity relative both to each other and to randomized controlled trials. While randomized controlled trials can achieve the highest degree of internal validity when cleanly implemented in the field, the availability of large, nationally representative data sets offers the opportunity for a high degree of external validity using non-experimental methods. We argue that each method has merits in some context and they are complements rather than substitutes.

scholarly journals Increasing Social Behaviour through Self-Management Strategy at the Children with Autism in the Inclusive Kindergarten

2018 ◽  
Author(s):  
Marlina - Marlina
Keyword(s):  
External Validity ◽  
Management Strategy ◽  
Social Behaviors ◽  
Children With Autism ◽  
Self Management ◽  
Social Response ◽  
Response Scale ◽  
Video Recordings ◽  
The Social ◽  
Internal And External Validity

This study aims to increase these social behaviors children with autism through self-management strategy (SMS by peers. The participants of this study were three children with autism and three normal students in the Kindergarten School. The effectiveness of the intervention was measured in the learning process, recess, and physical exercise activities. The data were collected through video recordings for 10 minutes. In addition, this study has validated the data for both internal and external validity by using the Social Response Scale to the class teachers and special teachers. The results show that the SMS that was mediated by peers has an impact on the social behaviors, including in starting the conversation, starting the game, and keeping the interaction of the children with autism. Finally, some limitations and further research are discussed.

scholarly journals Who’s in and Who’s Out? Selection Bias in Aging Research

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 822-822
Author(s):  
Elizabeth Rose Mayeda ◽  
Eleanor Hayes-Larson ◽  
Hailey Banack
Keyword(s):  
Selection Bias ◽  
External Validity ◽  
Sample Selection ◽  
Internal Validity ◽  
Causal Effects ◽  
Aging Research ◽  
Selection Processes ◽  
The People ◽  
Biased Estimates ◽  
Internal And External Validity

Abstract Selection bias presents a major threat to both internal and external validity in aging research. “Selection bias” refers to sample selection processes that lead to statistical associations in the study sample that are biased estimates of causal effects in the population of interest. These processes can lead to: (1) results that do not generalize to the population of interest (threat to external validity) or (2) biased effect estimates (associations that do not represent causal effects for any population, including the people in the sample; a threat to internal validity). In this presentation, we give an overview of selection bias in aging research. We will describe processes that can give rise to selection bias, highlight why they are particularly pervasive in this field, and present several examples of selection bias in aging research. We end with a brief summary of strategies to prevent and correct for selection bias in aging research.

scholarly journals Dysphagia Therapy in Adults with a Tracheostomy: A Scoping Review Protocol

2021 ◽  
Author(s):  
Waiza Kadri ◽  
Rhiannon Halfpenny ◽  
Breege Whiten ◽  
Christina Smith ◽  
Siofra Mulkerrin
Keyword(s):  
Scoping Review ◽  
Best Practice ◽  
Data Extraction ◽  
Grey Literature ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Future Research ◽  
Limited Information ◽  
Best Practice Guidelines ◽  
Dysphagia Therapy

Abstract Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice.Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually.Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.

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