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The auditory alerting cue would then compensate for this decreased validity effect.
We looked to alternative methods to routinely measure compliance because human auditing has decreased validity and reliability inherent in the methodology.
Older age has [ 11, 36] or has not [ 6] been associated with decreased validity of self-reports, while narrow age window in our study (57 68 years) might explain the found minimal age effect.
Decreased validity of the effect measure in epidemiological studies can be regarded as introduced in four hierarchical steps – confounding, misrepresentation, misclassification and analytical alteration of the effect measure [ 1].
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There are limitations to this analysis that could decrease validity.
While response shift is usually thought to increase the validity of evaluation results [ 12- 18], effects related to implicit theories of change are generally thought to decrease validity.
We consider this to be a serious problem, as the chance to produce the expected results in experimental studies increases with decreasing validity of the studies.
Studies have investigated validity among people with cognitive impairment or dementia and have found decreasing validity along with decreasing level of cognitive function (Kørner et al., 2006; Müller-Thomsen, Arlt, Mann, Mass, & Ganzer, 2005; Smalbrugge, Jongenelis, Pot, Beekman, & Eefsting, 2008).
The lack of diagnoses is a crucial limitation that may have decreased the validity of the results.
Therefore the lack of specific exclusion criteria in six reviewed papers may have decreased the validity of findings.
In our study, the requirement to obtain written consent for contact details to be passed to researchers, and again at the point of study recruitment, was likely to lead to decreased external validity.
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