{
  "study_id": "NCT07407595",
  "agent": "baseline",
  "run": 1,
  "p_primary_hypothesis_supported": 0.35,
  "effect_direction": "other: small and uncertain in sign; slight lean toward reduced excitability (lower plateau/slope) in the pain-expectation group",
  "effect_size_90pct_interval": {"low": -0.8, "high": 0.6, "metric": "Cohen's d for the between-group difference in change in excitability from baseline to post-cream (positive = excitability increases more, or falls less, in the pain-expectation group)"},
  "moderator_prediction": "Higher pain catastrophizing / kinesiophobia participants may show larger excitability changes because threat appraisal is stronger, but with n=22 per arm no moderator effect is likely to be significant; effectively none detectable.",
  "claim_ids_used": [],
  "rationale": "Small (44 total, ~22/arm), unblinded, single-lab TMS study with an objective, noisy outcome (MEP I/O curves). Expectation effects largely vanish on objective measures (OLP objective SMD ~0.09), and a verbal-only nocebo manipulation without actual pain is weak; FDI measured while cream is on the forearm. Pre-registered psychology base rate ~44%. Power for d~0.4 at n=22/arm is ~25%. Offsetting upward: three Boltzmann parameters and two post time points give multiple chances for a significant group x time effect, and threat-of-pain literature reports modulation (often MEP suppression). Direction ambiguous in the literature, so the interval spans zero with a slight lean negative."
}