B. Timoney, P. Guasoni, K. Zade, S. Bach, D. Tropea
Gene Ontology (GO) Biological Process overrepresentation analysis is widely used to interpret gene lists from genetic studies, yet results depend critically on the background (universe/reference list) against which enrichment is tested. This paper examines how genome-exome background mismatch alters GO Biological Process significance and induces annotation-driven bias. First, Monte Carlo simulations across multiple input gene list sizes show that enrichment p-values shift systematically when lists sampled from an exome-like universe are tested against a genome background (and vice versa), producing both inflation and deflation of significance depending on GO term composition; these shifts increase with gene list size. Second, applied analyses of gene lists derived from Genome-Wide Association Studies (GWAS) and Whole Exome Studies (WES) across brain, immune, and metabolic domains demonstrate that background choice changes the set of significant GO IDs, yielding reference-specific terms consistent with both Type I errors (false positives) and Type II errors (false negatives). Because genome backgrounds are commonly used by default, the practical risk is greatest when WES-derived lists are analyzed with genome reference lists. To support reproducible best practice, we provide a simple command set for selecting and documenting study-appropriate backgrounds and for assessing sensitivity of GO Biological Process results to the chosen universe.