The reference distribution the design supplies
The experiments that could have happened
An adaptive trial's allocation is a function of the outcomes it will later be compared against, so the ordinary analysis rejects a true null 9.2% of the time. Hold the outcomes fixed, re-run the rule that assigned them, and count — the same statistic against a reference distribution the trial could actually have drawn from is back at 4.0%.
The test that needs the rule
A randomisation test assumes almost nothing about the data and one thing about the experiment. Tell it a fair coin produced an allocation that an adaptive rule produced — which is what every off-the-shelf permutation routine does — and it rejects 8.0% of true nulls where knowing the rule gives 4.0%.
The plus one and the round number
A sampled randomisation test counts the observed allocation as one of its own reference draws, and the correction is invisible at B = 19, 39, 59 and 999 — every value anybody uses. At B = 20 the version without it is an 8.00% test where the corrected one is 3.80%, and the convention protecting everybody is a preference for round numbers minus one.
What the exactness buys
Against a z test calibrated to reject exactly 5% of true nulls on this design, the randomisation test loses nineteen points of power. What it buys is that the calibration needs the success rate — which moves the critical value from 1.668 to 2.718 and is the quantity the trial was run to find out.
The null the exactness is for
A permutation test is exact under the hypothesis that the treatment changed nothing for anybody. Under the hypothesis it changed nothing on average, with a quarter of the units treated and the effect varying between them, it rejects a true null 22.93% of the time.
A statistic that is exact twice
Dividing the difference in means by its own separate-variance standard error before permuting takes the rejection rate under a true weak null from 20.47% to 6.07%, keeps the exactness under the sharp null at 4.07%, and costs 0.8 points of power against a real effect. At an even split it changes nothing at all, in every draw.