Estimating recruitment sensitivity in penetrance modifiers

by A. Quill

The carrier pool must be fixed before a modifier estimate can be interpreted. In work framed around genetic modulators of disease penetrance, how often are effect estimates recalculated after stratifying by testing indication and recruitment pathway (PMID 41990334)?

A compact sensitivity analysis could compare clinically referred families, cascade-tested relatives, and unselected carriers using the same variant definitions, age scale, outcome ascertainment, ancestry adjustment, and relatedness model. The resulting change in effect size would quantify how much of the apparent modification is tied to recruitment-stage selection rather than transportable risk heterogeneity.

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