scholarly journals Inference about causation from examination of familial confounding (ICE FALCON): a model for assessing causation analogous to Mendelian randomization

2020 ◽  
Vol 49 (4) ◽  
pp. 1259-1269
Author(s):  
Shuai Li ◽  
Minh Bui ◽  
John L Hopper

Abstract Background We developed a method to make Inference about Causation from Examination of FAmiliaL CONfounding (ICE FALCON) using observational data for related individuals and considering changes in a pair of regression coefficients. ICE FALCON has some similarities to Mendelian randomization (MR) but uses in effect all the familial determinants of the exposure, not just those captured by measured genetic variants, and does not require genetic data nor make strong assumptions. ICE FALCON can assess tracking of a measure over time, an issue often difficult to assess using MR due to lack of a valid instrumental variable. Methods We describe ICE FALCON and present two empirical applications with simulations. Results We found evidence consistent with body mass index (BMI) having a causal effect on DNA methylation at the ABCG1 locus, the same conclusion as from MR analyses but providing about 2.5 times more information per subject. We found evidence that tracking of BMI is consistent with longitudinal causation, as well as familial confounding. The simulations supported the validity of ICE FALCON. Conclusions There are conceptual similarities between ICE FALCON and MR, but empirically they are giving similar conclusions with possibly more information per subject from ICE FALCON. ICE FALCON can be applied to circumstances in which MR cannot be applied, such as when there is no a priori genetic knowledge and/or data available to create a valid instrumental variable, or when the assumptions underlying MR analysis are suspect. ICE FALCON could provide insights into causality for a wide range of public health questions.

2019 ◽  
Author(s):  
Padraig Dixon ◽  
William Hollingworth ◽  
Sean Harrison ◽  
Neil M Davies ◽  
George Davey Smith

AbstractEstimates of the marginal effect of measures of adiposity such as body mass index (BMI) on healthcare costs are important for the formulation and evaluation of policies targeting adverse weight profiles. Many existing estimates of this association are affected by endogeneity bias caused by simultaneity, measurement error and omitted variables. The contribution of this study is to avoid this bias by using a novel identification strategy – random germline genetic variation in an instrumental variable analysis – to identify the presence and magnitude of the causal effect of BMI on inpatient hospital costs. We also use data on genetic variants to undertake much richer testing of the sensitivity of results to potential violations of the instrumental variable assumptions than is possible with existing approaches. Using data on over 300,000 individuals, we found effect sizes for the marginal unit of BMI more than 50% larger than multivariable effect sizes. These effects attenuated under sensitivity analyses, but remained larger than multivariable estimates for all but one estimator. There was little evidence for non-linear effects of BMI on hospital costs. Within-family estimates, intended to address dynastic biases, were null but suffered from low power. This paper is the first to use genetic variants in a Mendelian Randomization framework to estimate the causal effect of BMI (or any other disease/trait) on healthcare costs. This type of analysis can be used to inform the cost-effectiveness of interventions and policies targeting the prevention and treatment of overweight and obesity, and for setting research priorities.


2017 ◽  
Author(s):  
Lai Jiang ◽  
Karim Oualkacha ◽  
Vanessa Didelez ◽  
Antonio Ciampi ◽  
Pedro Rosa ◽  
...  

AbstractIn Mendelian randomization (MR), genetic variants are used to construct instrumental variables, which enable inference about the causal relationship between a phenotype of interest and a response or disease outcome. However, standard MR inference requires several assumptions, including the assumption that the genetic variants only influence the response through the phenotype of interest. Pleiotropy occurs when a genetic variant has an effect on more than one phenotype; therefore, a pleiotropic genetic variant may be an invalid instrumental variable. Hence, a naive method for constructing instrumental variables may lead to biased estimation of the causality between the phenotype and the response. Here, we present a set of intuitive methods (Constrained Instrumental Variable methods [CIV]) to construct valid instrumental variables and perform adjusted causal effect estimation when pleiotropy exists, focusing particularly on the situation where pleiotropic phenotypes have been measured. Our approach includes an automatic and valid selection of genetic variants when building the instrumental variables. We also provide details of the features of many existing methods, together with a comparison of their performance in a large series of simulations. CIV methods performed consistently better than many comparators across four different pleiotropic violations of the MR assumptions. We analyzed data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) Mueller et al. (2005) to disentangle causal relationships of several biomarkers with AD progression. The results showed that CIV methods can provide causal effect estimates, as well as selection of valid instruments while accounting for pleiotropy.


Author(s):  
John R. Thompson ◽  
Cosetta Minelli ◽  
Fabiola Del Greco M

AbstractMendelian randomization (MR) is a technique that seeks to establish causation between an exposure and an outcome using observational data. It is an instrumental variable analysis in which genetic variants are used as the instruments. Many consortia have meta-analysed genome-wide associations between variants and specific traits and made their results publicly available. Using such data, it is possible to derive genetic risk scores for one trait and to deduce the association of that same risk score with a second trait. The properties of this approach are investigated by simulation and by evaluating the potentially causal effect of birth weight on adult glucose level. In such analyses, it is important to decide whether one is interested in the risk score based on a set of estimated regression coefficients or the score based on the true underlying coefficients. MR is primarily concerned with the latter. Methods designed for the former question will under-estimate the variance if used for MR. This variance can be corrected but it needs to be done with care to avoid introducing bias. MR based on public data sources is useful and easy to perform, but care must be taken to avoid false precision or bias.


2018 ◽  
Vol 48 (3) ◽  
pp. 713-727 ◽  
Author(s):  
Eleanor Sanderson ◽  
George Davey Smith ◽  
Frank Windmeijer ◽  
Jack Bowden

Abstract Background Mendelian randomization (MR) is a powerful tool in epidemiology that can be used to estimate the causal effect of an exposure on an outcome in the presence of unobserved confounding, by utilizing genetic variants that are instrumental variables (IVs) for the exposure. This has been extended to multivariable MR (MVMR) to estimate the effect of two or more exposures on an outcome. Methods and results We use simulations and theory to clarify the interpretation of estimated effects in a MVMR analysis under a range of underlying scenarios, where a secondary exposure acts variously as a confounder, a mediator, a pleiotropic pathway and a collider. We then describe how instrument strength and validity can be assessed for an MVMR analysis in the single-sample setting, and develop tests to assess these assumptions in the popular two-sample summary data setting. We illustrate our methods using data from UK Biobank to estimate the effect of education and cognitive ability on body mass index. Conclusion MVMR analysis consistently estimates the direct causal effect of an exposure, or exposures, of interest and provides a powerful tool for determining causal effects in a wide range of scenarios with either individual- or summary-level data.


Author(s):  
Fernando Pires Hartwig ◽  
Kate Tilling ◽  
George Davey Smith ◽  
Deborah A Lawlor ◽  
Maria Carolina Borges

Abstract Background Two-sample Mendelian randomization (MR) allows the use of freely accessible summary association results from genome-wide association studies (GWAS) to estimate causal effects of modifiable exposures on outcomes. Some GWAS adjust for heritable covariables in an attempt to estimate direct effects of genetic variants on the trait of interest. One, both or neither of the exposure GWAS and outcome GWAS may have been adjusted for covariables. Methods We performed a simulation study comprising different scenarios that could motivate covariable adjustment in a GWAS and analysed real data to assess the influence of using covariable-adjusted summary association results in two-sample MR. Results In the absence of residual confounding between exposure and covariable, between exposure and outcome, and between covariable and outcome, using covariable-adjusted summary associations for two-sample MR eliminated bias due to horizontal pleiotropy. However, covariable adjustment led to bias in the presence of residual confounding (especially between the covariable and the outcome), even in the absence of horizontal pleiotropy (when the genetic variants would be valid instruments without covariable adjustment). In an analysis using real data from the Genetic Investigation of ANthropometric Traits (GIANT) consortium and UK Biobank, the causal effect estimate of waist circumference on blood pressure changed direction upon adjustment of waist circumference for body mass index. Conclusions Our findings indicate that using covariable-adjusted summary associations in MR should generally be avoided. When that is not possible, careful consideration of the causal relationships underlying the data (including potentially unmeasured confounders) is required to direct sensitivity analyses and interpret results with appropriate caution.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yuquan Wang ◽  
Tingting Li ◽  
Liwan Fu ◽  
Siqian Yang ◽  
Yue-Qing Hu

Mendelian randomization makes use of genetic variants as instrumental variables to eliminate the influence induced by unknown confounders on causal estimation in epidemiology studies. However, with the soaring genetic variants identified in genome-wide association studies, the pleiotropy, and linkage disequilibrium in genetic variants are unavoidable and may produce severe bias in causal inference. In this study, by modeling the pleiotropic effect as a normally distributed random effect, we propose a novel mixed-effects regression model-based method PLDMR, pleiotropy and linkage disequilibrium adaptive Mendelian randomization, which takes linkage disequilibrium into account and also corrects for the pleiotropic effect in causal effect estimation and statistical inference. We conduct voluminous simulation studies to evaluate the performance of the proposed and existing methods. Simulation results illustrate the validity and advantage of the novel method, especially in the case of linkage disequilibrium and directional pleiotropic effects, compared with other methods. In addition, by applying this novel method to the data on Atherosclerosis Risk in Communications Study, we conclude that body mass index has a significant causal effect on and thus might be a potential risk factor of systolic blood pressure. The novel method is implemented in R and the corresponding R code is provided for free download.


2019 ◽  
Vol 28 (R2) ◽  
pp. R170-R179 ◽  
Author(s):  
Neil M Davies ◽  
Laurence J Howe ◽  
Ben Brumpton ◽  
Alexandra Havdahl ◽  
David M Evans ◽  
...  

Abstract Mendelian randomization (MR) is increasingly used to make causal inferences in a wide range of fields, from drug development to etiologic studies. Causal inference in MR is possible because of the process of genetic inheritance from parents to offspring. Specifically, at gamete formation and conception, meiosis ensures random allocation to the offspring of one allele from each parent at each locus, and these are unrelated to most of the other inherited genetic variants. To date, most MR studies have used data from unrelated individuals. These studies assume that genotypes are independent of the environment across a sample of unrelated individuals, conditional on covariates. Here we describe potential sources of bias, such as transmission ratio distortion, selection bias, population stratification, dynastic effects and assortative mating that can induce spurious or biased SNP–phenotype associations. We explain how studies of related individuals such as sibling pairs or parent–offspring trios can be used to overcome some of these sources of bias, to provide potentially more reliable evidence regarding causal processes. The increasing availability of data from related individuals in large cohort studies presents an opportunity to both overcome some of these biases and also to evaluate familial environmental effects.


PLoS Genetics ◽  
2021 ◽  
Vol 17 (4) ◽  
pp. e1009525
Author(s):  
Mark Gormley ◽  
James Yarmolinsky ◽  
Tom Dudding ◽  
Kimberley Burrows ◽  
Richard M. Martin ◽  
...  

Head and neck squamous cell carcinoma (HNSCC), which includes cancers of the oral cavity and oropharynx, is a cause of substantial global morbidity and mortality. Strategies to reduce disease burden include discovery of novel therapies and repurposing of existing drugs. Statins are commonly prescribed for lowering circulating cholesterol by inhibiting HMG-CoA reductase (HMGCR). Results from some observational studies suggest that statin use may reduce HNSCC risk. We appraised the relationship of genetically-proxied cholesterol-lowering drug targets and other circulating lipid traits with oral (OC) and oropharyngeal (OPC) cancer risk using two-sample Mendelian randomization (MR). For the primary analysis, germline genetic variants in HMGCR, NPC1L1, CETP, PCSK9 and LDLR were used to proxy the effect of low-density lipoprotein cholesterol (LDL-C) lowering therapies. In secondary analyses, variants were used to proxy circulating levels of other lipid traits in a genome-wide association study (GWAS) meta-analysis of 188,578 individuals. Both primary and secondary analyses aimed to estimate the downstream causal effect of cholesterol lowering therapies on OC and OPC risk. The second sample for MR was taken from a GWAS of 6,034 OC and OPC cases and 6,585 controls (GAME-ON). Analyses were replicated in UK Biobank, using 839 OC and OPC cases and 372,016 controls and the results of the GAME-ON and UK Biobank analyses combined in a fixed-effects meta-analysis. We found limited evidence of a causal effect of genetically-proxied LDL-C lowering using HMGCR, NPC1L1, CETP or other circulating lipid traits on either OC or OPC risk. Genetically-proxied PCSK9 inhibition equivalent to a 1 mmol/L (38.7 mg/dL) reduction in LDL-C was associated with an increased risk of OC and OPC combined (OR 1.8 95%CI 1.2, 2.8, p = 9.31 x10-05), with good concordance between GAME-ON and UK Biobank (I2 = 22%). Effects for PCSK9 appeared stronger in relation to OPC (OR 2.6 95%CI 1.4, 4.9) than OC (OR 1.4 95%CI 0.8, 2.4). LDLR variants, resulting in genetically-proxied reduction in LDL-C equivalent to a 1 mmol/L (38.7 mg/dL), reduced the risk of OC and OPC combined (OR 0.7, 95%CI 0.5, 1.0, p = 0.006). A series of pleiotropy-robust and outlier detection methods showed that pleiotropy did not bias our findings. We found limited evidence for a role of cholesterol-lowering in OC and OPC risk, suggesting previous observational results may have been confounded. There was some evidence that genetically-proxied inhibition of PCSK9 increased risk, while lipid-lowering variants in LDLR, reduced risk of combined OC and OPC. This result suggests that the mechanisms of action of PCSK9 on OC and OPC risk may be independent of its cholesterol lowering effects; however, this was not supported uniformly across all sensitivity analyses and further replication of this finding is required.


Biostatistics ◽  
2020 ◽  
Author(s):  
Andrew J Grant ◽  
Stephen Burgess

Summary Valid estimation of a causal effect using instrumental variables requires that all of the instruments are independent of the outcome conditional on the risk factor of interest and any confounders. In Mendelian randomization studies with large numbers of genetic variants used as instruments, it is unlikely that this condition will be met. Any given genetic variant could be associated with a large number of traits, all of which represent potential pathways to the outcome which bypass the risk factor of interest. Such pleiotropy can be accounted for using standard multivariable Mendelian randomization with all possible pleiotropic traits included as covariates. However, the estimator obtained in this way will be inefficient if some of the covariates do not truly sit on pleiotropic pathways to the outcome. We present a method that uses regularization to identify which out of a set of potential covariates need to be accounted for in a Mendelian randomization analysis in order to produce an efficient and robust estimator of a causal effect. The method can be used in the case where individual-level data are not available and the analysis must rely on summary-level data only. It can be used where there are any number of potential pleiotropic covariates up to the number of genetic variants less one. We show the results of simulation studies that demonstrate the performance of the proposed regularization method in realistic settings. We also illustrate the method in an applied example which looks at the causal effect of urate plasma concentration on coronary heart disease.


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