Internal validity in evidence-based medicine refers to the extent to which study results are caused by the independent variable and not by confounding factors.

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Internal validity is about whether the study’s observed effect can be attributed to the intervention itself rather than to other explanations or biases. The statement matches this idea by stating that results are caused by the independent variable and not by confounding factors. When a study has high internal validity, researchers have effectively controlled for alternative explanations—through randomization, proper blinding, allocation concealment, consistent procedures, and unbiased outcome assessment—so the causal link between the intervention and the outcome is believable.

Generalizability, or external validity, is about applying findings to other populations or settings, which is a different concern. Speed of obtaining results isn’t a measure of validity, and statistical significance concerns whether an observed effect is unlikely to be due to chance, not whether that effect can be causally attributed to the intervention without confounding.