Evidence quality

Internal validity

How well a study design and conduct support a trustworthy answer for its own participants.

What it means

Definition

Internal validity. Internal validity concerns bias, confounding, measurement and analysis within the study. Without internal validity, broad applicability is secondary because the result may not be reliable even for the study sample.

What it can tell you

It can help clarify what sort of evidence or claim is being discussed.

What it cannot tell you

It cannot, by itself, prove that the headline is accurate or clinically important.

Headline trap

Why this matters in headlines

Poor randomisation or heavy loss to follow-up can weaken internal validity.