False-Positive Calls of Reimplemented Published Analyses for Covert Command-Following on Electroencephalograms Recorded Without Study Commands

Goldfine 2011, a spectral covert command-following analysis on clinical electroencephalography without commands, called 23.3% (95% CI 20.2%–26.6%) positive—well above its stated 5% benchmark.

• Why it matters: Covert command-following claims depend on low false positives, but published analyses may misfire when applied to electroencephalograms recorded without study commands.
• What they did: The cross-sectional study reimplemented 11 published analyses and tested them on 974 clinical electroencephalography patients plus 730 new patients, including 38 with prolonged disorders of consciousness and 544 comatose post–cardiac arrest.
• The result: All three analyses that exceeded 5% also detected genuine responses, and Goldfine 2011’s command-level correction reduced new-patient false calls to 0.8% (and 2.4% after arrest) while detecting 93.4% of stroke imagery-versus-rest sessions.

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