![]() ![]() The details of the IRB/oversight body that provided approval or exemption for the research described are given below:Īll participants included in the EstBB cohort provided informed consent for the data and samples to be used for scientific purposes. I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. was additionally funded from the European Union's Horizon Europe research and innovation programme under grant agreement No 964874. and PRG1197 to K.F.) and an EMBO Installation grant (No. ![]() This work was funded by Estonian Research Council grants (PRG1414 to E.O. ![]() The authors have declared no competing interest. We show with a plethora of sensitivity analyses that the identified causal effects are robust, and propose ways for further methodological developments. ![]() We apply the AB-IVR method on the Estonian Biobank data and show that the microbiome has a causal role in numerous diseases including migraine, depression and irritable bowel syndrome. We rely on the recent studies showing that antibiotic treatment has a cumulative long-term effect on the microbiome, resulting in individuals with higher antibiotic usage to have a more perturbed microbiome. Here we propose a novel framework of antibiotic instrumental variable regression (AB-IVR) for estimating the causal relationships between microbiome and various diseases. As simple covariate adjustment is not likely to account for all potential confounders, the idea of instrumental variable (IV) analysis is worth exploiting. Since randomised trials in human subjects are often unethical or difficult to pursue, analytical methods to derive causal effects from observational data deserve attention. Assessing causality is undoubtedly one of the key questions in microbiome studies for the upcoming years. ![]()
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