Mendelian Randomization - Background: The Problem of Spurious Findings in Observational Epidemiology

Background: The Problem of Spurious Findings in Observational Epidemiology

An important focus of observational epidemiology is the identification of modifiable causes of common diseases that are of public health interest. In order to have firm evidence that a recommended public health intervention will have the desired beneficial effect, the observed association between the particular risk factor and disease must imply that the risk factor actually causes the disease.

Well-known successes include the identified causal links between smoking and lung cancer, and between blood pressure and stroke. However, there have also been notable failures when identified exposures were later shown by randomised controlled trials (RCTs) to be non-causal. For instance, it has now been shown that hormone replacement therapy will not prevent cardiovascular disease, as was previously thought, and may have other adverse health effects (Rossouw et al. 2002). The reason for such spurious findings in observational epidemiology is most likely to be confounding by social, behavioural or physiological factors which are difficult to control for and particularly difficult to measure accurately. Moreover, many findings cannot be replicated by RCTs for ethical reasons.

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