CONFIRM: Governing Scientific Reporting for Trustworthy Agentic Neuroimaging
Organizations: TReNDS Center, Atlanta, GA, USA · Georgia Institute of Technology, Atlanta, GA, USA · University of Houston–Clear Lake, Houston, TX, USA · McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA ·
Abstract
Large language model (LLM) agents can autonomously run neuroimaging analyses from research questions to reported findings. Existing agentic systems use tools to check that code runs and reported values match its output, but rely on LLM judgment to decide which results warrant scientific reporting. We show that LLM judges endorse site-confounded findings even when the confound is presented as evidence. We present CONFIRM, a framework that separates running an analysis from deciding which findings to report. CONFIRM encodes each hypothesis as a machine-readable, pre-specified analysis plan that fixes the claim and its pass criteria before computing results. It then filters results through five deterministic gates (search history and multiplicity, confounds, power, analytic stability, and replication) under three configurable reporting standards, from least to most demanding: Screen, Replicate, and Full. Failed claims receive diagnoses that guide follow-up analyses. To evaluate reporting decisions at the claim level, we introduce NeuroClaimBench, comprising 489 executable neuroimaging claims with frozen data, including literature-supported findings and 150 controls designed to violate individual methodological requirements. On NeuroClaimBench, CONFIRM falsely supports at most 3% of controls, compared with 23--38% for the baselines, while recovering up to 61% of literature-supported claims. When auditing an existing agent, CONFIRM reduces false support on controls from 23% to 0% while retaining the agent's literature-supported claims. Its diagnostic feedback also produces more supported revisions than Self-Refine with fewer LLM calls. Together, CONFIRM and NeuroClaimBench show that basing reporting decisions on pre-specified analysis plans and deterministic gates is essential for trustworthy autonomous scientific discovery.
Figures & tables
| What can go wrong | Gate | Passes when (default) | Designed control |
|---|---|---|---|
| Many tests were tried and only the best one is reported | Search history and multiplicity | The effect stays significant after correcting for every test tried ( ). | Broad-search |
| A site or scanner difference creates an apparent effect | Measured confounds | No measured site, scanner, field-strength, or software variable differs between the groups while being left out of the analysis. | Site-confounded |
| The sample is too small to trust the result | Power | The planned design can detect a modest reference effect, by default , with at least 80% power. | Underpowered |
| The result depends on arbitrary analysis choices | Analytic stability | At least 60% of reasonable alternative analyses give a consistent result ( Steegen et al., 2016 ) . | – |
| The effect does not appear again in new data | Independent replication | The effect has the same direction and in every replication dataset. | Nonreplicating |
| Setting | Rec. | FS | Ctrl. |
|---|---|---|---|
| Defaults | 41 | 11 | 0 |
| Gate thresholds | |||
| Stability | 41 | 11 | 0 |
| Minimum power | 41 | 11 | 0 |
| Confound | 35–41 | 11 | 0 |
| Replication | 37–41 | 5–11 | 0 |
| Method | LLM calls | Candidates | Supported | Parents | Holdout |
|---|---|---|---|---|---|
| evaluated | on search | (%) | (%) | ||
| Failure-blind retry | 765 | 3,073 | 49 | 9 | 7 |
| Self-Refine | 1,301 | 2,161 | 54 | 11 | 9 |
| CONFIRM diagnosis | 653 | 2,971 | 70 | 11 | 17 |
Appendix figures & tables11 assets
Supplementary material from the paper’s appendix.
Appendix
| Gate | Decision rule | Default |
|---|---|---|
| Search history: provenance | The search and the data used to select the claim are documented, and selection did not use the full dataset. | – |
| Search history: multiplicity | Scalar: in the locked direction. Brain-wide: at least one region with Benjamini–Hochberg over hypotheses, in the locked direction. | |
| Measured confounds | Every required covariate is declared, and no site, scanner, field-strength, or software variable is both associated with the predictor and omitted from the covariates. | |
| Power | The planned design detects , a literature value when available and otherwise, at the minimum power. | power |
| Analytic stability | The fraction of consistent analysis variants (forks) is at least , over 24 forks for scalar claims and 6 for brain-wide claims. | |
| Replication | Scalar: locked direction and in every replication cohort. Brain-wide: pattern correlation, replicated-region fraction, and Dice at or above the analysis-plan thresholds, with at least three shared regions and 50% feature coverage. | ; , , |
| Verdict | Assignment rule | Example attached reasons |
|---|---|---|
| confirmed | Every gate passes for the pre-specified analysis plan. | All gate states pass. |
| fragile | Search history or multiplicity requirements, measured-confound checks, or analytic stability fail. | unverifiable_search_provenance ; confound_incomplete ; failed stability. |
| under_powered | The planned design cannot detect at the required power. | Reference effect, planned sample size, and achieved power. |
| non_replicated | The locked analysis plan fails in a designated replication cohort. | Missing compatible outcome, wrong sign, or non-significant effect. |
| Split | Source | Executable | Support | Withhold | Unresolved |
|---|---|---|---|---|---|
| Scientific | 332 | 279 | 51 | 19 | 209 |
| External-transfer | 62 | 60 | 18 | 30 | 12 |
| Designed controls | 150 | 150 | 0 | 150 | 0 |
| Total | 544 | 489 | 69 | 199 | 221 |
| Evaluation | Recovery | Literature false support | Control false support |
|---|---|---|---|
| Matched common-scalar comparison | |||
| VERITAS-adapted | 65 [45, 81] | 40 [16, 68] | 38 [30, 46] |
| NeuroClaw-adapted | 48 [30, 67] | 13 [2, 40] | 23 [16, 30] |
| Direct LLM judge | 55 [36, 73] | 20 [4, 48] | 29 [22, 37] |
| Significance filter | 52 [33, 70] | 13 [2, 40] | 28 [21, 36] |
| CONFIRM-Screen | 61 [42, 78] | 40 [16, 68] | 3 [1, 8] |
| Removed gate | literature recovery | literature false support | control false support |
|---|---|---|---|
| Search history: provenance | +0 | +0 | +0 |
| Search history: multiplicity | +0 | +0 | +0 |
| Measured confounds | +2 | +0 | +24 |
| Power | +0 | +0 | +1 |
| Analytic stability | +0 | +0 | +0 |
| Replication | +8 | +26 | +2 |
| Label | Withheld | Repl. | Mult. | Stab. | Power | Conf. |
|---|---|---|---|---|---|---|
| Supported | 59 | 87 | 73 | 73 | 20 | 3 |
| Unsupported | 89 | 94 | 71 | 71 | 0 | 0 |
| Holdout outcome | Confirmed | Withheld |
|---|---|---|
| Evaluated claims | 65 | 144 |
| Full standard passed | 16 | 5 |
| Replication gate passed | 41 | 22 |
| Failed gates (overlapping) | ||
| Search history / multiplicity | 6 | 124 |
| Measured confounds | 0 | 4 |
| Regime | Reported (%) | Added (%) | Calls | Holdout (%) | Control (%) |
|---|---|---|---|---|---|
| No feedback | 28.6 | n/a | n/a | 5.7 | 0 |
| Self-critique | 35.4 | 9.5 | 1,357 | 6.4 | 0 |
| CONFIRM diagnosis | 37.5 | 12.5 | 894 | 8.9 | 0 |
| Arm | Generated | Retained | Evaluated | Supported | Parents (%) |
| CONFIRM diagnosis, , | 3,187 | 3,059 | 2,971 | 70 | 11 |
| Failure-blind retry, , | 3,275 | 3,178 | 3,073 | 49 | 9 |
| Self-Refine, , | 3,259 | 2,361 | 2,161 | 54 | 11 |
| Designed controls, , | 334 | 296 | 293 | 0 | 0 |
| Designed controls, , | 13,371 | 12,313 | 10,716 | 0 | 0 |
AI Agents for Scientific Discovery
AI agents for scientific discovery use language models, tools, and experiments to generate, test, and refine scientific knowledge.
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