Preprint on Phenotypic Reliability

Biomarkers of behavior and psychiatric illness for cognitive and clinical neuroscience remain out of reach^1–4. Suboptimal reliability of biological measurements, such as functional magnetic resonance imaging (fMRI), is increasingly cited as a primary culprit for discouragingly large sample size requirements and poor reproducibility of brain-based biomarker discovery^1,5–7. In response, steps are being taken towards optimizing MRI reliability and increasing sample sizes^8–11, though this will not be enough. Optimizing biological measurement reliability and increasing sample sizes are necessary but insufficient steps for biomarker discovery; this focus has overlooked the ‘other side of the equation’ – the reliability of clinical and cognitive assessments – which are often suboptimal or unassessed.

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