Understanding false positives in control conditions: a simulation study of post-hoc testing in low-powered neuroimaging trials
Bibliographic record
Abstract
Randomized controlled trials (RCTs) are essential for evaluating treatment efficacy, typically comparing active interventions to control conditions. In situations where blinding is impractical—such as in psychological therapies or physical rehabilitation—waitlist controls are often used to account for natural symptom progression and test–retest variability. This study examines the biases introduced by post-hoc analyses under conditions of low statistical power, particularly in neuroimaging research. Through large-scale simulations involving 100 million datasets with varying sample sizes, treatment effects, and test–retest variability, the study demonstrates that the common practice of conducting post-hoc tests only on brain regions showing significant interaction effects can substantially increase the false positive rate in the control condition. These findings underscore the relevance of Berkson’s paradox in interpreting unexpected control group outcomes and caution against overinterpreting such results. A complementary neuroimaging simulation reinforces these conclusions, emphasizing the need for critical scrutiny when evaluating significant effects in control groups. Overall, this work challenges conventional post-hoc testing strategies and advocates for a more nuanced and statistically informed interpretation of results, especially in studies with limited power.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.054 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".