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E. C. Tolman emphasized the purposiveness of behavior — the idea that much of our behavior is goal-directed. For instance, employees who aim for a promotion work diligently to meet their targets. Tolman argued that when classical conditioning and operant conditioning occur, the organism acquires certain expectations. In classical conditioning, a child might fear a dog because they expect it to bite. In operant conditioning, a person might consistently work overtime because they expect a...
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Cognitive learning is based on purposive behavior, incidental learning, and insight learning.
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Albert Bandura's observational learning, also known as imitation or modeling, occurs when a person observes and imitates another's behavior. It is a quicker process than operant conditioning. A well-known example is the Bobo doll study, where children who saw an adult acting aggressively towards the doll were more likely to act aggressively when left alone, compared to those who observed a nonaggressive adult. Many psychologists view observational learning as a form of latent learning...
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The nursing process provides a clinical decision-making framework for patients and families to establish and implement a personalized care plan. Since part of the nurse's duties is to teach patients, the steps of the nursing process are the most effective way to approach instruction. The nursing process and the teaching-learning process are inextricably linked.
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Updated: Jul 20, 2025

Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
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Evaluating and improving real-world evidence with Targeted Learning.

Susan Gruber1, Rachael V Phillips2, Hana Lee3

  • 1Putnam Data Sciences, LLC, Cambridge, MA, USA. sgruber@putnamds.com.

BMC Medical Research Methodology
|August 2, 2023
PubMed
Summary
This summary is machine-generated.

The Targeted Learning roadmap systematically guides real-world evidence (RWE) generation and evaluation. Applying it revealed data limitations for causal inference, but enabled estimation of treatment effects under explicit assumptions.

Keywords:
Causal inferenceReal-world evidenceTMLETargeted learning

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Area of Science:

  • Epidemiology
  • Biostatistics
  • Health Informatics

Background:

  • Real-world evidence (RWE) is crucial for regulatory and clinical decisions.
  • RWE is derived from diverse sources, including observational studies and real-world data in clinical trials.
  • Systematic evaluation of RWE validity and interpretability is essential.

Purpose of the Study:

  • To illustrate a principled approach for assessing RWE validity and interpretability using the Targeted Learning (TL) roadmap.
  • To identify barriers in causal effect estimation from observational studies.
  • To explore methods for overcoming barriers and robustifying RWE.

Main Methods:

  • Application of the TL roadmap to a published observational study on ritodrine hydrochloride and pulmonary edema.
  • Formulation of alternative causal questions to address data limitations.
  • Exploration of options for overcoming unmeasured confounding.

Main Results:

  • The TL roadmap highlighted issues leading to revised causal questions for more reliable RWE.
  • Lack of sufficient data to establish a causal dose-response curve was identified.
  • Estimation of the effect of any ritodrine versus none was possible under explicit assumptions.

Conclusions:

  • Systematic evaluation of RWE quality and reliability is paramount before clinical and regulatory use.
  • The TL roadmap provides a framework for thorough, transparent, and realistic RWE assessment.
  • Routine implementation of the TL roadmap in decision-making processes is recommended.