A Comparison Of Robust Mendelian Randomization Methods Using Summary Data

AbstractThe number of Mendelian randomization analyses including large numbers of genetic variants is rapidly increasing. This is due to the proliferation of genome-wide association studies, and the desire to obtain more precise estimates of causal effects. Since it is unlikely that all genetic variants will be valid instrumental variables, several robust methods have been proposed. We compare nine robust methods for Mendelian randomization based on summary data that can be implemented using standard statistical software. Methods were compared in three ways: by reviewing their theoretical properties, in an extensive simulation study, and in an empirical example to investigate the effect of body mass index on coronary artery disease risk. In the simulation study, the overall best methods, judged by mean squared error, were the contamination mixture method and the mode based estimation method. These methods generally had well-controlled Type 1 error rates with up to 50% invalid instruments across a range of scenarios. Outlier-robust methods such as MR-Lasso, MR-Robust, and MR-PRESSO, had the narrowest confidence intervals in the empirical example. They performed well when most variants were valid instruments with a few outliers, but less well with several invalid instruments. With isolated exceptions, all methods performed badly when over 50% of the variants were invalid instruments. Our recommendation for investigators is to perform a variety of robust methods that operate in different ways and rely on different assumptions for valid inferences to assess the reliability of Mendelian randomization analyses.