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dc.contributor.authorWatson, JA
dc.contributor.authorLeopold, SJ
dc.contributor.authorSimpson, JA
dc.contributor.authorDay, NPJ
dc.contributor.authorDondorp, AM
dc.contributor.authorWhite, NJ
dc.date.accessioned2020-12-10T01:03:31Z
dc.date.available2020-12-10T01:03:31Z
dc.date.issued2019-01-28
dc.identifierpii: 43154
dc.identifier.citationWatson, J. A., Leopold, S. J., Simpson, J. A., Day, N. P. J., Dondorp, A. M. & White, N. J. (2019). Collider bias and the apparent protective effect of glucose-6-phosphate dehydrogenase deficiency on cerebral malaria. ELIFE, 8, https://doi.org/10.7554/eLife.43154.
dc.identifier.issn2050-084X
dc.identifier.urihttp://hdl.handle.net/11343/253644
dc.description.abstractCase fatality rates in severe falciparum malaria depend on the pattern and degree of vital organ dysfunction. Recent large-scale case-control analyses of pooled severe malaria data reported that glucose-6-phosphate dehydrogenase deficiency (G6PDd) was protective against cerebral malaria but increased the risk of severe malarial anaemia. A novel formulation of the balancing selection hypothesis was proposed as an explanation for these findings, whereby the selective advantage is driven by the competing risks of death from cerebral malaria and death from severe malarial anaemia. We re-analysed these claims using causal diagrams and showed that they are subject to collider bias. A simulation based sensitivity analysis, varying the strength of the known effect of G6PDd on anaemia, showed that this bias is sufficient to explain all of the observed association. Future genetic epidemiology studies in severe malaria would benefit from the use of causal reasoning.
dc.languageEnglish
dc.publisherELIFE SCIENCES PUBLICATIONS LTD
dc.titleCollider bias and the apparent protective effect of glucose-6-phosphate dehydrogenase deficiency on cerebral malaria
dc.typeJournal Article
dc.identifier.doi10.7554/eLife.43154
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titleeLife
melbourne.source.volume8
dc.rights.licenseCC BY
melbourne.elementsid1370395
melbourne.contributor.authorSimpson, Julie
dc.identifier.eissn2050-084X
melbourne.accessrightsOpen Access


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