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Concept
Mendelian randomization
Résumé
In epidemiology, Mendelian randomization (commonly abbreviated to MR) is a method using measured variation in genes to interrogate the causal effect of an exposure on an outcome. Under key assumptions (see below), the design reduces both reverse causation and confounding, which often substantially impede or mislead the interpretation of results from epidemiological studies.
The study design was first proposed in 1986 and subsequently described by Gray and Wheatley as a method for obtaining unbiased estimates of the effects of a putative causal variable without conducting a traditional randomized controlled trial (i.e. the "gold standard" in epidemiology for establishing causality). These authors also coined the term Mendelian randomization.
One of the predominant aims of epidemiology is to identify modifiable causes of health outcomes and disease especially those of public health concern. In order to ascertain whether modifying a particular trait (e.g. via an intervention, treatment or policy change) will convey a beneficial effect within a population, firm evidence that this trait causes the outcome of interest is required. However, many observational epidemiological study designs are limited in the ability to discern correlation from causation - specifically whether a particular trait causes an outcome of interest, is simply related to that outcome (but does not cause it) or is a consequence of the outcome itself. Only the former will be beneficial within a public health setting where the aim is to modify that trait to reduce the burden of disease. There are many epidemiological study designs that aim to understand relationships between traits within a population sample, each with shared and unique advantages and limitations in terms of providing causal evidence, with the "gold standard" being randomized controlled trials.
Well-known successful demonstrations of causal evidence consistent across multiple studies with different designs include the identified causal links between smoking and lung cancer, and between blood pressure and stroke.
Source officielle
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