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Tytuł:
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Correlation without a cause: an epidemiological odyssey.
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Autorzy:
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Davey Smith G; Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK.
Phillips AN; Institute for Global Health, University College London, London, UK.
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Źródło:
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International journal of epidemiology [Int J Epidemiol] 2020 Feb 01; Vol. 49 (1), pp. 4-14.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: [London] Oxford University Press.
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MeSH Terms:
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Causality*
Cholesterol, HDL*
Coronary Disease*
Triglycerides*
Cholesterol, LDL ; Epidemiologic Studies ; Humans ; Mendelian Randomization Analysis ; Risk Factors
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Grant Information:
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MC_UU_00011/1 United Kingdom MRC_ Medical Research Council
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Substance Nomenclature:
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0 (Cholesterol, HDL)
0 (Cholesterol, LDL)
0 (Triglycerides)
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Entry Date(s):
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Date Created: 20200404 Date Completed: 20200617 Latest Revision: 20200617
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Update Code:
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20240105
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DOI:
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10.1093/ije/dyaa016
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PMID:
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32244255
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In the 1980s debate intensified over whether there was a protective effect of high-density lipoprotein cholesterol (HDL-C) or an adverse effect of triglycerides on coronary heart disease (CHD) risk. In a 1991 paper reprinted in the IJE we suggested that the high degree of correlation between the two, together with plausible levels of measurement error, made it unlikely that conventional epidemiological approaches could contribute to causal understanding. The consensus that HDL-C was protective, popularly reified in the notion of 'good cholesterol', strengthened over subsequent years. Reviewing the biostatistical and epidemiological literature from before and after 1991 we suggest that within the observational epidemiology pantheon only Mendelian randomization studies-that began to appear at the same time as the initial negative randomized controlled trials-made a meaningful contribution. It is sobering to realize that many issues that appear suitable targets for epidemiological investigation are simply refractory to conventional approaches. The discipline should surely revisit this and other high-profile cases of consequential epidemiological failure-such as that with respect to vitamin E supplementation and CHD risk-rather than pass them over in silence.
(© The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)
