A randomized controlled trial compares two antihypertensive regimens. After analysis, the researchers perform multiple sub-group comparisons and find a significant benefit in a subgroup of elderly diabetics (p = 0.03). This finding is best characterized as:
- A A definitive finding requiring immediate guideline change
- B A Type II error due to insufficient sample size
- C A hypothesis-generating finding prone to Type I error from multiple comparisons ✓
- D Confounding by indication in the subgroup
Correct answer: C. A hypothesis-generating finding prone to Type I error from multiple comparisons
Explanation
Post-hoc subgroup analyses performed without pre-specification inflate the risk of Type I error (false positive) because of multiple comparisons. When many subgroups are tested, some will reach p < 0.05 by chance alone. This finding should be treated as hypothesis-generating for future confirmatory trials, not a basis for guideline change. Type II error means missing a real effect due to low power. Confounding by indication pertains to observational studies.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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