Repurposing large health insurance claims data to estimate genetic and environmental contributions in 560 phenotypes (2019) Lakhani et al.

I think there may be different ways of expressing risk, which can confuse things. The one measure I understand is the risk of an identical twin of a patient getting an illness in their lifetime. For RA that is about25%. For ank spend it is nearer 60%. For lupus I think it is 30% but I forget.
 
Londinium said:
Thanks for posting, Chris. I'd be interested to know how ME/CFS compares with depression on the 'Environment' point - can anybody here who's able to query the data have a look? I would *guess* that MDD would have quite a strong component that varies with zip code - e.g. see the discussion about 'shit life syndrome' on this brilliant article on Blackpool.
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So, to try and answer my own question, I've had a play with the data and I think what it shows is this (my knowledge of heritability statistics is pretty much nil, so please treat with caution and I'd welcome any comments/corrections):

Chronic fatigue syndrome
Heritability, h2 = 0.575, p=0.007
Shared Environment, c2 = -0.106, p=0.464 <--no significant association, 95% confidence intervals are above and below zero

Major depressive disorder
Heritability, h2 = 0.180, p=0.006
Shared Environment, c2 = 0.181, p<0.001

Anxiety disorder
Heritability, h2 = 0.349, p<0.001
Shared Environment, c2 =0.077, p=0.013

Looking at that, it appears to me that:

  • Whilst relying on insurance data may be problematic due to coding errors (e.g. depression or anxiety being misdiagnosed/miscoded as CFS), there are substantial differences between the results for each condition in aggregate;
  • CFS shows a strong heritable component and no statistically significant 'shared environment' component. i.e. if two siblings have CFS, it's not because of parental influence
  • This would seem to contradict, for example, any paediatric CFS study that indicates a certain parental personality is a risk factor for a child developing CFS.
  • MDD and anxiety disorders do show a shared environment component, in contrast to CFS. This (to me) provides yet more strong evidence - if any were needed - that CFS is not a mood disorder, that CFS is not just a form of depression or anxiety.
  • (I'll admit I was a bit surprised that anxiety disorder had such a strong genetic component - however, unlike CFS, it does still have a shared environment component as well)
 
strategist said:
I am not sure what to compare their findings to. Where can I find out what "accepted estimates of genetic risk for major diseases like RA, lupus, diabetes" are?

On their website there is a comparison to published literature and the differences appear substantial. http://apps.chiragjpgroup.org/catch/

But I find all this hard to interpret and understand.
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I did wonder if that graph - which if I'm reading it correctly suggests that published studies shower a stronger heretibility component to this insurance-based study - could be explained by the lower specificity/accuracy of insurance codings and also, perhaps, publication bias.
 
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