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      Improving the visualization, interpretation and analysis of two-sample summary data Mendelian randomization via the Radial plot and Radial regression

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          Abstract

          Background

          Summary data furnishing a two-sample Mendelian randomization (MR) study are often visualized with the aid of a scatter plot, in which single-nucleotide polymorphism (SNP)–outcome associations are plotted against the SNP–exposure associations to provide an immediate picture of the causal-effect estimate for each individual variant. It is also convenient to overlay the standard inverse-variance weighted (IVW) estimate of causal effect as a fitted slope, to see whether an individual SNP provides evidence that supports, or conflicts with, the overall consensus. Unfortunately, the traditional scatter plot is not the most appropriate means to achieve this aim whenever SNP–outcome associations are estimated with varying degrees of precision and this is reflected in the analysis.

          Methods

          We propose instead to use a small modification of the scatter plot—the Galbraith Radial plot—for the presentation of data and results from an MR study, which enjoys many advantages over the original method. On a practical level, it removes the need to recode the genetic data and enables a more straightforward detection of outliers and influential data points. Its use extends beyond the purely aesthetic, however, to suggest a more general modelling framework to operate within when conducting an MR study, including a new form of MR-Egger regression.

          Results

          We illustrate the methods using data from a two-sample MR study to probe the causal effect of systolic blood pressure on coronary heart disease risk, allowing for the possible effects of pleiotropy. The Radial plot is shown to aid the detection of a single outlying variant that is responsible for large differences between IVW and MR-Egger regression estimates. Several additional plots are also proposed for informative data visualization.

          Conclusions

          The Radial plot should be considered in place of the scatter plot for visualizing, analysing and interpreting data from a two-sample summary data MR study. Software is provided to help facilitate its use.

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          Most cited references9

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          'Mendelian randomization': can genetic epidemiology contribute to understanding environmental determinants of disease?

          Associations between modifiable exposures and disease seen in observational epidemiology are sometimes confounded and thus misleading, despite our best efforts to improve the design and analysis of studies. Mendelian randomization-the random assortment of genes from parents to offspring that occurs during gamete formation and conception-provides one method for assessing the causal nature of some environmental exposures. The association between a disease and a polymorphism that mimics the biological link between a proposed exposure and disease is not generally susceptible to the reverse causation or confounding that may distort interpretations of conventional observational studies. Several examples where the phenotypic effects of polymorphisms are well documented provide encouraging evidence of the explanatory power of Mendelian randomization and are described. The limitations of the approach include confounding by polymorphisms in linkage disequilibrium with the polymorphism under study, that polymorphisms may have several phenotypic effects associated with disease, the lack of suitable polymorphisms for studying modifiable exposures of interest, and canalization-the buffering of the effects of genetic variation during development. Nevertheless, Mendelian randomization provides new opportunities to test causality and demonstrates how investment in the human genome project may contribute to understanding and preventing the adverse effects on human health of modifiable exposures.
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            Explaining heterogeneity in meta-analysis: a comparison of methods.

            Exploring the possible reasons for heterogeneity between studies is an important aspect of conducting a meta-analysis. This paper compares a number of methods which can be used to investigate whether a particular covariate, with a value defined for each study in the meta-analysis, explains any heterogeneity. The main example is from a meta-analysis of randomized trials of serum cholesterol reduction, in which the log-odds ratio for coronary events is related to the average extent of cholesterol reduction achieved in each trial. Different forms of weighted normal errors regression and random effects logistic regression are compared. These analyses quantify the extent to which heterogeneity is explained, as well as the effect of cholesterol reduction on the risk of coronary events. In a second example, the relationship between treatment effect estimates and their precision is examined, in order to assess the evidence for publication bias. We conclude that methods which allow for an additive component of residual heterogeneity should be used. In weighted regression, a restricted maximum likelihood estimator is appropriate, although a number of other estimators are also available. Methods which use the original form of the data explicitly, for example the binomial model for observed proportions rather than assuming normality of the log-odds ratios, are now computationally feasible. Although such methods are preferable in principle, they often give similar results in practice. Copyright 1999 John Wiley & Sons, Ltd.
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              A note on graphical presentation of estimated odds ratios from several clinical trials.

              To display a number of estimates of a parameter obtained from different studies it is common practice to plot a sequence of confidence intervals. This can be useful but is often unsatisfactory. An alternative display is suggested which represents intervals as points on a bivariate graph, and which has advantages. When the data are estimates of odds ratios from studies with a binary response, it is argued that for either type of plot, a log scale should be used rather than a linear scale.
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                Author and article information

                Journal
                Int J Epidemiol
                Int J Epidemiol
                ije
                International Journal of Epidemiology
                Oxford University Press
                0300-5771
                1464-3685
                August 2018
                28 June 2018
                28 June 2018
                : 47
                : 4
                : 1264-1278
                Affiliations
                [1 ]MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
                [2 ]Institute for Biomedicine, Eurac Research, Bolzano, Italy
                [3 ]Department of Health Sciences, University of Leicester, Leicester, UK
                [4 ]Population Health and Occupational Disease, NHLI, Imperial College, London, UK
                Author notes
                Corresponding author. MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK. E-mail: jack.bowden@ 123456bristol.ac.uk
                Author information
                http://orcid.org/0000-0002-8169-5531
                Article
                dyy101
                10.1093/ije/dyy101
                6124632
                29961852
                d0a5f88e-8d9e-48bc-9f49-cb9d95b85ee2
                © The Author(s) 2018. Published by Oxford University Press on behalf of the International Epidemiological Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 April 2018
                : 14 May 2018
                Page count
                Pages: 15
                Categories
                Methods

                Public health
                two sample summary data mendelian randomization,scatter plot,heterogeneity statistics,radial plot,radial mr-egger

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