Commentary: Mendelian randomization-inspired causal inference in the absence of genetic data

Luisa Zuccolo*, Michael V. Holmes

*Corresponding author for this work

Research output: Contribution to journalComment/debate (Academic Journal)peer-review

52 Citations (Scopus)


Studying the long-term causal effects of alcohol drinking is notoriously difficult. Epidemiological studies that use conventional analytical approaches are likely to be confounded and affected by reporting/recall bias and reverse causality, specifically in the form of the sick quitter effect (individuals quitting or never starting to consume alcohol due to underlying ill health).1 Decades of observational data showing J-shaped relationships of alcohol with risk of disease and in particular cardiovascular disease,2 fuelled by confirmation bias, have resulted in alcohol policies such that individuals are recommended to drink in moderation, due to putative cardioprotective effects. Critically, randomized controlled trials (RCTs) to investigate the long-term effects of alcohol drinking are not feasible for reasons including lack of suitable and ethical interventions and extended duration (and hence cost and likely high loss to follow-up).

Original languageEnglish
Article numberdyw327
Pages (from-to)962-965
Number of pages4
JournalInternational Journal of Epidemiology
Issue number3
Publication statusPublished - 1 Jun 2017


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