False-Positive Calls of Reimplemented Published Analyses for Covert Command-Following on Electroencephalograms Recorded Without Study Commands
Auteurs : A. Gorenshtein, Y. Adiniaev, Y. Barash, E. Klang, O. Daniel
Résumé scientifique
ObjectiveTo measure how often published electroencephalographic analyses for covert command-following call patients positive without commands, and their detection of genuine responses. MethodsThis cross-sectional study applied 11 reimplemented published analyses to electroencephalograms without commands: 974 clinical electroencephalography patients and, with rules fixed, 730 new patients; 38 with prolonged disorders of consciousness; and 544 comatose patients after cardiac arrest. Outcomes: false calls (share called positive) against a 5% benchmark, and genuine-response detection. ResultsThree of 10 command-following analyses called significantly more than 5% of clinical electroencephalography patients positive, replicated in new patients: Goldfine 2011, a spectral test, 23.3% (95% CI, 20.2%-26.6%), above its stated 5%; du Bois 2026, a criterion for entry to brain-computer interface training, 22.2% (95% CI, 19.2%-25.5%); and Guger 2018, a P300 accuracy threshold, 13.8% (95% CI, 11.5%-16.3%), near its approximate 12% chance rate (24.5% over 2 runs). The other 7 called 0.0% to 6.9%. After cardiac arrest: 11.5% to 27.3%. All 3 detected genuine responses. Identified contributors: a variance ignoring within-command dependence (Goldfine 2011), selection over configurations and times (du Bois 2026) and a permissive threshold (Guger 2018). Goldfine 2011s command-level correction, fixed before testing, called 0.8% of new patients and 2.4% after arrest, detecting 93.4% of stroke imagery-versus-rest sessions but few between imagery types. InterpretationReimplemented published analyses called up to 27% of patients positive without commands, more with repeated runs. A positive result needs its complete call rules false-call rate and detection at that rate; imagery-versus-rest detection may reflect task engagement, not imagery.
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