MR Dictionary

INstrument Strength Independent of Direct Effect (InSIDE) assumption

The InSIDE assumption is a further assumption for MR-Egger and related MR methods (additional to core and additional MR assumptions). 

The assumption states that the association between the genetic instrumental variable (IV) and exposure is not correlated with the (pleiotropic) path from the genetic IV to the outcome that is independent of the exposure of interest. If unbalanced pleiotropy is present and the InSIDE assumption is violated, this is likely to result in a biased MR-Egger effect. Violation of the InSIDE assumption can occur if several genetic variants influence the outcome via the same pleiotropic path or if several variants are related to the same (unmeasured) confounder(s) of the exposure-outcome association, as the genetic IV-exposure and genetic IV-outcome associations would be, in part, via those confounders.  The latter (whereby the genetic variants influence the outcome via confounders of the exposure-outcome association) is sometimes referred to as correlated pleiotropy. If the genetic variants influence the outcome in a way that is independent of the exposure, this is sometimes referred to as uncorrelated pleiotropy.

References

Other terms in 'Sources of bias and limitations in MR':