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Chunk #53 — Discussion — Limitations of the proposed approach

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Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression.
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One further limitation of this approach is the assumption that the same causal effect is identified by multiple IVs. This assumption is not unique to our approach, as it is commonly made in IV analyses with multiple IVs. The presence of ‘treatment effect heterogeneity' is a complicating factor in causal analyses more generally, as it is not clear how to interpret a causal effect estimate if its magnitude depends on the nature of the intervention on the exposure. This is an important avenue for further research.