Mendelian randomization uses genetic variations fixed at birth to assess associations with outcomes, reducing confounding compared to prospective observational studies.

“the conventional ways of taking things apart with prospective observational studies like framingham there's a there's a limited amount you can of the certainty of your conclusions because of confounding you can't deal with”

“what mandelion randomization allows you to do is to come a lot closer to causality because for example you can identify groups of genes that are associated where changes in the gene are associated with a little lower cholesterol or a little higher cholesterol and when you lump together a bunch of those different genes that can have different makeups because you can change the makeup of a gene pretty easily you can see fairly substantial differences in cholesterol so what you've got is information on somebody that's fixed at Birth and you see is that associated with a difference in outcome you've gotten rid of a lot of stuff in the middle”