Mendelian randomization (MR) is an established approach for assessing the causal effects of heritable exposures on outcomes. Outcomes of interest often include binary clinical endpoints, but may also include censored survival times. We explore the implications of both the Cox proportional hazard model and the additive hazard model in the context of MR, with a specific emphasis on two‐stage methods. We show that naive application of standard MR approaches to censored survival times may induce significant bias. Through simulations and analysis of data from the Women's Health Initiative, we provide practical advice on modeling survival outcomes in MRs.

中文翻译：

---

具有生存结果的孟德尔随机化分析

孟德尔随机化 (MR) 是一种用于评估可遗传暴露对结果的因果影响的既定方法。感兴趣的结果通常包括二元临床终点，但也可能包括截尾生存时间。我们在 MR 的背景下探索了 Cox 比例风险模型和加性风险模型的含义，特别强调了两阶段方法。我们表明，标准 MR 方法对审查生存时间的幼稚应用可能会导致显着的偏差。通过对来自妇女健康倡议的数据进行模拟和分析，我们提供了关于 MR 生存结果建模的实用建议。