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2016 ; 103
(4
): 965-78
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Best (but oft-forgotten) practices: the design, analysis, and interpretation of
Mendelian randomization studies
#MMPMID26961927
Haycock PC
; Burgess S
; Wade KH
; Bowden J
; Relton C
; Davey Smith G
Am J Clin Nutr
2016[Apr]; 103
(4
): 965-78
PMID26961927
show ga
Mendelian randomization (MR) is an increasingly important tool for appraising
causality in observational epidemiology. The technique exploits the principle
that genotypes are not generally susceptible to reverse causation bias and
confounding, reflecting their fixed nature and Mendel?s first and second laws of
inheritance. The approach is, however, subject to important limitations and
assumptions that, if unaddressed or compounded by poor study design, can lead to
erroneous conclusions. Nevertheless, the advent of 2-sample approaches (in which
exposure and outcome are measured in separate samples) and the increasing
availability of open-access data from large consortia of genome-wide association
studies and population biobanks mean that the approach is likely to become
routine practice in evidence synthesis and causal inference research. In this
article we provide an overview of the design, analysis, and interpretation of MR
studies, with a special emphasis on assumptions and limitations. We also consider
different analytic strategies for strengthening causal inference. Although
impossible to prove causality with any single approach, MR is a highly
cost-effective strategy for prioritizing intervention targets for disease
prevention and for strengthening the evidence base for public health policy.