bio-causal-genomics-mediation-analysis

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Decompose total effects into direct and indirect paths through mediators using mediation, CMAverse 4-way, HIMA/HIMA2 high-dimensional, BAMA, two-step / MVMR mediation, or double-ML medDML. Use when testing whether a molecular phenotype (expression, methylation, protein) mediates a treatment-outcome relationship, decomposing exposure-mediator interaction via VanderWeele 4-way, screening high-dimensional EWAS mediators, or running MR-based mediation when sequential ignorability is implausible.

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The instructions your AI receives, as published by pku-yuangroup/openai4s in skills/bioskills/bio-causal-genomics-mediation-analysis/SKILL.md and read by ahel’s review.

Version Compatibility

Reference examples tested with: R 4.3+, mediation 4.5.0+, CMAverse 0.1.0+ (GitHub BS1125/CMAverse), HIMA >= 2.3.0 (GitHub YinanZheng/HIMA; archived from CRAN 2026-07), bama 1.3+, causalweight 1.0.5+ (medDML), MVMR 0.4+, TwoSampleMR 0.6+, EValue 4.1+, gesttools 1.3+, ipw 1.0.11+.

Before using code patterns, verify installed versions match. If versions differ:

  • R: packageVersion('<pkg>') then ?function_name to verify parameters
  • HIMA must be pinned at >= 2.3.0 for the code patterns below; the formula interface hima(formula, data.pheno, data.M, mediator.type, penalty, ...) was introduced in 2.3.0. On HIMA 2.2.x the classic engine is the top-level hima(X, Y, M, COV.XM=, COV.MY=, Y.family=, penalty=) (positional order X, Y, M) with no formula interface; HIMA 2.2.x is NOT API-compatible with the examples here.
  • In 2.3+ the classic engine is hima_classic(X, M, Y, COV.XM=, COV.MY=, Y.type=) (positional order X, M, Y; outcome type via Y.type, not Y.family); use it only to reproduce the original 2016-2021 SIS+penalty pipelines.

If code throws an error, introspect the installed package (?hima, args(cmest)) and adapt the example to match the actual API rather than retrying.

Mediation Analysis

"Does expression of GENE_X mediate the SNP-to-disease effect?" -> Decompose the total effect of a treatment (genotype, exposure) on an outcome into direct and indirect paths through one or more mediators, with explicit handling of exposure-mediator interaction, sensitivity to unmeasured confounding, and high-dimensional mediator screening.

  • R (single-mediator, observational, sequential-ignorability assumed): mediation::mediate(med_model, out_model, treat='X', mediator='M', boot=TRUE, sims=5000)
  • R (4-way decomposition with exposure-mediator interaction): CMAverse::cmest(...EMint=TRUE, estimation='paramfunc', inference='bootstrap', nboot=1000)
  • R (high-dimensional / EWAS mediators): HIMA::hima(Y ~ X + covariates, data.pheno, data.M, mediator.type='gaussian', penalty='DBlasso') (modern v2.3+ formula interface)
  • R (MR-based mediation): two-step TwoSampleMR with independent instruments OR MVMR::ivw_mvmr for joint direct effect
  • R (doubly-robust double-ML): causalweight::medDML(y, d, m, x)

Sequential ignorability (no unmeasured confounder of treatment-mediator, mediator-outcome, treatment-outcome) is the single load-bearing assumption of observational mediation and is fundamentally untestable. Every report should include a sensitivity result (Imai's rho via medsens() or a mediational E-value).

Algorithmic Taxonomy

MethodFrameworkHandles E-M interactionHigh-D mediatorsMin nFails when
Baron-Kenny (1986)Additive regression-based product/differenceNoNo~100Any non-linearity, interaction, or binary outcome; deprecated for causal inference
Imai mediation R (Imai 2010 Psychol Methods)Counterfactual ACME/ADE with bootstrapYes (via interaction term in outcome model)No~200Sequential ignorability violated; exposure-induced M-Y confounder; rare binary outcome with logistic outcome model
VanderWeele 4-way (VanderWeele 2014 Epidemiology 25:749; 2015 OUP)CDE + PIE + INTref + INTmed decompositionNativeNo~300Without interaction term reduces to standard mediation; binary outcome needs rare-disease assumption
CMAverse (Shi 2021 Epidemiology 32:e20)6 estimators: regression (rb), weighting (wb), IORW (iorw), natural effect models (ne), MSM (msm), g-formula (gformula)YesNo (single M, or M-vector)~300Estimator-specific; wb fails with rare exposure; msm needs censoring weights for survival
HIMA1 / hima_classic (Zhang 2016 Bioinformatics 32:3150)SIS screen by beta (M->Y) + MCP penaltyNoYes (up to ~10k)~150 + p>>nMisses mediators with strong alpha and weak beta; screening-step false-negatives
HIMA2 / hima (Perera 2022 BMC Bioinformatics 23:296)SIS screen by alpha*beta (indirect effect) + de-biased Lasso (DBlasso)No (linear by default)Yes~150Outcome family limited (gaussian/binomial); HIMA-Cox for survival; HIMA-Pois for count
HILAMA (Wang et al 2025)High-D mediation with latent confoundersNoYes (>= 100k)~500Newer; benchmarks evolving; requires latent-factor specification
BAMA (Song 2020 Biometrics)Bayesian high-D continuous shrinkageNoYes (~5k)~200Slow MCMC; prior sensitivity for very weak mediators
Two-step MR / network MR (Burgess 2015 IJE 44:484)IV-based at each step with INDEPENDENT instrumentsImplicit (no interaction modeling)One mediator at a timeLarge summary-stat samplesSame SNP used for E and M (violates exclusion); horizontal pleiotropy; Steiger reversal of M->E direction
MVMR-mediation (Carter & Sanderson 2021 Eur J Epidemiol 36:465-478)Total minus direct via MVMRImplicitSingle mediatorLarge GWAS samples for both E and MConditional F < 10 for either exposure; correlated instruments
medDML (Farbmacher 2022 Econometrics J 25:277)Double-debiased ML, doubly-robustLimited (depends on learner)Moderate (sparsity-friendly)~500Severe overlap violations; cross-fitting variance with small n

Methodology evolves; verify against the current CMAverse vignette and the Steen / Vansteelandt natural-effects-model literature before locking analytic choices. Difference-in-coefficients and product-of-coefficients give identical estimates in fully linear-Gaussian models but DIVERGE for any non-linear outcome model (logistic, Cox, Poisson); the counterfactual ACME from mediation::mediate() is the correct quantity for non-linear outcomes.

4-Way Decomposition Framework

VanderWeele 4-way explicitly separates effects from exposure-mediator interaction:

Total Effect = CDE + INTref + INTmed + PIE
ComponentMeaningActive when
CDEControlled direct effect (with mediator fixed at reference level)E directly affects Y
INTrefInteraction-reference -- needs interaction AND exposureE*M interaction with mediator at reference
INTmedMediated interaction -- needs interaction AND exposure AND mediationE shifts M which then interacts with E
PIEPure indirect effect (older "mediation" quantity)E shifts M which shifts Y additively

Without an exposure-mediator interaction term, INTref = INTmed = 0 and the decomposition collapses to CDE + PIE (= ADE + ACME). With interaction present, traditional ACME mixes PIE and INTmed; the 4-way separation is the only framework that disentangles them. Most epidemiology applications include the interaction term and report all four components (Valeri & VanderWeele 2013 Psychol Methods).

Decision Tree by Scenario

ScenarioRecommended pipeline
Observational, single measured mediator, no plausible E-M interaction, continuous outcomemediation::mediate() with boot=TRUE, sims=5000; always run medsens()
Observational, single mediator, suspected E-M interaction, any outcome familyCMAverse::cmest(..., EMint=TRUE) -> read CDE, PIE, INTref, INTmed
Observational, BINARY outcome, rare disease (< 10%)cmest(yreg='logistic', EMint=TRUE, casecontrol=FALSE) -- OR-based 4-way decomposition is valid under rare-disease
Observational, survival outcomecmest(yreg='coxph') OR HIMA::hima_cox for high-D; report HRs
High-D mediators (EWAS, transcriptome-wide), continuous outcomeHIMA::hima(formula, data.pheno, data.M, mediator.type='gaussian', penalty='DBlasso'); report sigcut (FDR threshold, default 0.05)
High-D mediators with latent confounding (very-high-D EWAS)HILAMA (2025)
High-D mediators with Bayesian shrinkage (small n, ~5k features)bama::bama()
Strong genetic IVs for exposure available, single mediator with own IVsTwo-step MR with independent instruments + Steiger filter on mediator
Both E and M have IVs but instruments are weak / correlatedMVMR-mediation with conditional F > 10 each
Observational with rich confounder set, want doubly-robust estimatecausalweight::medDML (double-debiased ML)
Longitudinal with time-varying confoundingg-formula via CMAverse::cmest(estimation='gformula') OR gfoRmula package
Exposure-induced confounder of M-Y existsInterventional indirect effects (Vansteelandt & Daniel 2017); CMAverse::cmest(estimation='msm')

Sequential Ignorability and Why It Always Needs Sensitivity

Observational mediation requires three no-unmeasured-confounding assumptions. The third (M-Y unmeasured confounder, after conditioning on E) is the most common violator in genomic mediation because biological confounders (cell composition, batch effects, technical mediators) frequently affect both M and Y.

Sequential ignorability untestable

Trigger: Always, by design.

Mechanism: No statistical test can detect an unmeasured confounder of M-Y. Bootstrap CIs assume the assumption holds; they do NOT propagate uncertainty about it.

Symptom: Significant ACME with no sensitivity reported -> reviewer rejects.

Fix: Report at least one of:

  • Imai's rho sensitivity: medsens(med_result, rho.by=0.05, sims=1000); the critical rho where ACME crosses 0; |rho_crit| > 0.3 is "reasonably robust" (Imai 2010), |rho_crit| < 0.1 is highly sensitive.
  • Mediational E-value (Smith & VanderWeele 2019 Epidemiology 30:835): minimum risk-ratio strength of an unmeasured confounder needed to nullify the observed indirect effect; computed via EValue::evalues.OLS() for linear outcomes or by-hand from ACME risk ratio bounds.
  • Reporting BOTH rho-based and E-value sensitivity is standard for high-stakes claims.

Methods-Section Defense of Sequential Ignorability

Template sentence for the methods write-up: "We assumed sequential ignorability conditional on {age, sex, ancestry PCs, cell composition, batch, smoking}. Robustness was assessed via Imai rho_crit at the ACME contrast (medsens, sims = 1000) and the mediational E-value on the risk-ratio scale (Smith & VanderWeele 2019 Epidemiology 30:835)."

Quantitative interpretation thresholds:

  • rho_crit: |rho_crit| > 0.3 robust; 0.1-0.3 moderately sensitive; < 0.1 highly sensitive (Imai 2010).
  • E-value: E > 2 robust to plausible biological confounding; 1.5-2 moderate; < 1.5 fragile (Smith & VanderWeele 2019).

For high-stakes claims (clinical, drug-target, regulatory submissions) report BOTH rho_crit and the mediational E-value; for exploratory work either alone suffices.

Exposure-induced M-Y confounder

Trigger: A covariate L sits between E and Y, AND is affected by E, AND confounds M-Y.

Mechanism: Standard regression-based mediation cannot adjust for L without blocking part of the indirect effect (collider stratification bias). Adjusting biases CDE; not adjusting biases ACME.

Symptom: Sensitivity to confounder set; ACME flips sign when L is added vs removed.

Operational identification: From the DAG, L is a covariate of M and Y that is also affected by E. VanderWeele TJ, Vansteelandt S & Robins JM 2014 (Epidemiology 25:300) give the criterion: if L is adjusted, part of the indirect E -> L -> M -> Y pathway is blocked; if L is not adjusted, L confounds the M-Y leg. Both are wrong under natural-effects; the natural indirect effect is simply not identified.

Fix: Switch to interventional indirect effects (Vansteelandt & Daniel 2017 Epidemiology 28:258), NOT natural indirect effects. Use CMAverse::cmest(estimation='msm') with stabilized inverse-probability weights (yields the randomized-interventional analogue), gfoRmula (parametric g-formula), or randomized/interventional indirect effects (Lin SH & VanderWeele TJ 2017 J Causal Inference 5:20150027). The interventional indirect is identified under weaker assumptions than the natural indirect.

HIMA covariate or data.pheno error

Trigger: data.pheno contains factor columns with NA, or formula references columns missing from data.pheno.

Mechanism: HIMA v2.3+ uses a formula interface and constructs the design matrix internally from data.pheno; missing values or unparseable formulas surface as cryptic glmnet errors.

Symptom: Pipeline fails inside hima() with a non-obvious storage.mode or model.matrix error.

Fix: Pre-clean data.pheno (drop NA rows for the variables in the formula; convert factors with factor(); ensure all RHS variables exist as columns). Example:

dat <- na.omit(dat[, c('outcome', 'exposure', 'age', 'sex', 'batch', 'pc1', 'pc2')])
dat$batch <- factor(dat$batch)
result <- hima(outcome ~ exposure + age + sex + batch + pc1 + pc2,
               data.pheno=dat, data.M=M_matrix, mediator.type='gaussian')

HIMA mediator-type vs outcome-type mismatch

Trigger: Survival outcome (Surv() on LHS) with mediator.type='compositional' chosen against text mediator panel; or count mediators passed as 'gaussian'.

Mechanism: HIMA v2.3+ auto-detects outcome family from the LHS of formula (continuous, binary, survival, count); mediator.type is set for the mediator data only ('gaussian', 'negbin', 'compositional'). Mismatching mediator-type to the actual mediator distribution biases the screening step.

Symptom: Hazard / rate ratios for indirect effects look implausible; many "significant" mediators fail replication.

Fix: Set mediator.type='gaussian' for continuous (e.g., methylation beta, log-CPM expression), 'negbin' for raw count (RNA-seq), 'compositional' for relative-abundance microbiome. Verify by ?hima in the installed version since the catalogue of mediator types has expanded across releases.

Bootstrap iterations too low

Trigger: sims=100 or sims=500 in early exploration left in for the final report.

Mechanism: ACME CIs from bootstrap have Monte-Carlo error that scales as 1/sqrt(sims); at sims=500 the 95% CI bounds have ~5% MC noise, enough to flip the conclusion at the boundary.

Symptom: Re-running mediate() with a different set.seed() gives substantially different CI bounds.

Fix: sims=1000 minimum for any reported result; sims=5000 for publication; sims=10000 if proximity to zero matters. BCa CIs (boot.ci.type='bca' in mediate()) are slightly more accurate than percentile CIs near zero but require more sims for stability.

Two-step MR instrument independence

Trigger: Same set of SNPs used as instruments for E in step 1 and for M in step 2.

Mechanism: If a SNP affects both E and M, the M-instrument violates exclusion restriction (the SNP-Y association is not exclusively through M). Estimates are biased toward the direct effect.

Symptom: Two-step MR shows large indirect effect; replacing M-instruments with non-overlapping SNPs makes it vanish.

Fix: Apply Steiger filter on the mediator: keep only SNPs where the SNP-M F-statistic exceeds SNP-E F-statistic (or where SNP explains more variance in M than E). For MVMR-mediation, require conditional F > 10 for each exposure independently (Sanderson 2019 IJE 48:713).

Difference vs product of coefficients diverge for non-linear outcomes

Trigger: Binary or survival outcome modeled with logistic / Cox.

Mechanism: Difference = total - direct; product = alpha * beta. Equivalent under linear-Gaussian; diverge under any link function. Counterfactual ACME from mediation::mediate() is the correct quantity; hand-computed product-of-coefficients on logistic output is biased except under rare-disease.

Fix: Report only counterfactual ACME (Imai or CMAverse). For OR-based 4-way decomposition on rare outcomes (<= 10%), Valeri & VanderWeele 2013 formulas apply; for common outcomes use risk-ratio scale or marginal effects rather than ORs.

Required Reporting for Publication

ComponentRequired
ACME estimate + 95% CI (BCa preferred)Yes
ADE + 95% CIYes
Total effectYes
Proportion mediatedYes when total > effect-size threshold
Bootstrap method + simspercentile / BCa; min 1000, recommend 5000
Sequential ignorability sensitivityrho_crit (medsens) OR mediational E-value
Exposure-mediator interaction testCoefficient + p; 4-way decomposition if significant
Confounder set justificationDAG description
Mediator measurement reliabilityCite
Sample size + missing-data handlingYes
Mediator / exposure scaleStandardized? log? raw?

Reference: AGReMA guideline (Lee H et al 2021 JAMA 326:1045) and MacKinnon 2008 Introduction to Statistical Mediation Analysis.

Reconciliation: Observational vs MR Mediation

PatternLikely causeAction
Observational ACME significant; MR-mediation nullUnmeasured M-Y confounding inflated observational estimate; OR weak IVs in MRRe-run observational with medsens(); if rho_crit < 0.1, trust MR null
Observational ACME null; MR-mediation significantMeasurement error in M attenuated observational estimateTrust MR (regression-dilution-free) IF instruments pass Steiger and pleiotropy tests (MR-Egger intercept, MR-PRESSO)
Both significant with same signConvergent evidenceHigh-confidence mediation; report effect size from the more-conservative estimate
Both significant with opposite signsAt least one is biased; revisit confounder structure and IV assumptionsDo not pool; investigate via cross-method sensitivity

Operational rule for high-stakes claims (clinical / drug-target mediation): Require (1) significant observational ACME, (2) Imai rho_crit > 0.2 OR mediational E-value > 1.5, (3) directionally consistent MR-mediation result OR documented absence of valid instruments. Single-method mediation claims should be reported as exploratory.

Anticipated Reviewer Pushback

PushbackStandard response
"Sequential ignorability?"Imai rho_crit reported via medsens; mediational E-value reported on the risk-ratio scale
"Exposure-induced confounder of M-Y?"DAG drawn; if L present, switch to CMAverse::cmest(estimation='msm') for interventional indirect effect (Vansteelandt & Daniel 2017)
"Why this bootstrap method?"BCa with sims=5000 for publication; percentile fallback when BCa fails to converge (acceleration estimate unstable at boundary)
"Why was MR-mediation not done?"If valid IVs for E and M exist: two-step MR or MVMR-mediation done (see code below); if not, documented absence of trans-instruments
"Mediator measured with error?"Regression calibration (Carroll 2006 Measurement Error in Nonlinear Models) OR sensitivity analysis assuming reliability r = 0.7 (Valeri & VanderWeele 2014)
"Why HIMA2 not BAMA?"HIMA2 = frequentist + FDR control + faster; BAMA = Bayesian when prior information is available; sample-size justification given against simulation rule-of-thumb
"Proportion mediated unstable?"When

Quantitative Thresholds

QuantityThresholdSource / Rationale
sims (bootstrap iterations)>= 1000 exploratory, >= 5000 publicationImai 2010; MC error scales 1/sqrt(sims)
Proportion mediated -- meaningful> 0.2Convention; weak guideline only -- effect size in absolute terms matters more (MacKinnon 2008)
Proportion mediated -- "most of the effect"> 0.5-0.8Convention
Imai rho_crit -- robust> 0.3Imai 2010 Psychol Methods 15:309
Imai rho_crit -- sensitive< 0.1Same
Mediational E-value -- robust> 2.0 (working convention; the original Smith & VanderWeele 2019 E-value framework does not prescribe a specific cutoff -- magnitude is context-dependent)Smith & VanderWeele 2019 Epidemiology 30:835
HIMA FDR cutoffBH FDR < 0.05Default; report q-values not raw p
MVMR conditional F per exposure> 10 eachSanderson 2019 IJE 48:713
Two-step MR -- F for both stages> 10 eachBurgess weak-instrument convention
Sample size -- single-mediator (Imai)>= 200 for stable bootstrapSimulation rule-of-thumb
Sample size -- HIMA EWAS>= 150 with p_mediators up to ~10kZhang 2016 simulations
Rare-outcome cutoff for OR-based 4-wayoutcome prevalence <= 10%Valeri & VanderWeele 2013

Working Code Patterns

Single-Mediator Observational with Sensitivity

Goal: Decompose a genotype-disease effect via measured molecular mediator with explicit sensitivity to unmeasured M-Y confounding.

Approach: Fit mediator and outcome models, bootstrap ACME/ADE, run medsens() for Imai rho-based sensitivity.

library(mediation)

med_model <- lm(expression ~ genotype + age + sex + pc1 + pc2 + pc3, data=dat)
out_model <- glm(disease ~ genotype + expression + age + sex + pc1 + pc2 + pc3,
                 data=dat, family=binomial)

med_result <- mediate(med_model, out_model,
                      treat='genotype', mediator='expression',
                      boot=TRUE, sims=5000, boot.ci.type='bca')
summary(med_result)

sens <- medsens(med_result, rho.by=0.05, effect.type='indirect', sims=1000)
summary(sens)

d0, z0, n0, tau.coef slots return ACME, ADE, proportion mediated, total effect.

4-Way Decomposition with Exposure-Mediator Interaction

Goal: Separate CDE, PIE, INTref, INTmed when exposure-mediator interaction is biologically plausible (e.g., gene-environment interaction modifying mediator effect).

Approach: Use CMAverse regression-based estimator with EMint=TRUE; bootstrap CIs.

library(CMAverse)

result_4way <- cmest(
  data=dat, model='rb',
  outcome='disease', exposure='genotype', mediator='expression',
  basec=c('age','sex','pc1','pc2'),
  EMint=TRUE,
  mreg=list('linear'), yreg='logistic',
  astar=0, a=1, mval=list(0),
  estimation='paramfunc', inference='bootstrap', nboot=1000
)
summary(result_4way)

CMAverse reports the 4-way decomposition (Vanderweele 2014): for continuous outcomes the components are cde, intref, intmed, pnie (or pie), te, pm; for non-continuous outcomes (logistic / Cox / Poisson) the ratio versions Rcde, Rpnde, Rtnde, Rpnie, Rtnie are reported. When EMint=TRUE, additional proportion-attributable-to-interaction terms (int, pe) are included. Verify column names with summary(result)$results in the installed CMAverse version, since naming has evolved.

High-Dimensional EWAS Mediation (HIMA2)

Goal: Among thousands of candidate CpG mediators, identify those mediating an exposure-outcome effect with FDR control.

Approach: HIMA v2.3+ uses a formula interface and auto-detects outcome family (Gaussian / binomial / Cox / Poisson). Screening + MCP/DBlasso penalisation + joint significance with BH; the sigcut argument controls the FDR threshold (default 0.05).

library(HIMA)

dat <- na.omit(dat[, c('outcome', 'exposure', 'age', 'sex', 'cell_pc1', 'cell_pc2')])
M_matrix <- as.matrix(beta_values)

result <- hima(
  outcome ~ exposure + age + sex + cell_pc1 + cell_pc2,
  data.pheno=dat,
  data.M=M_matrix,
  mediator.type='gaussian',          # 'negbin' for count, 'compositional' for microbiome
  penalty='DBlasso',                  # default; alternatives 'MCP', 'SCAD', 'lasso'
  scale=TRUE,
  sigcut=0.05,
  parallel=TRUE, ncore=8, verbose=TRUE
)
# result is a data.frame of significant mediators below sigcut

Shortened here. Read the whole file on GitHub.

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