PT - JOURNAL ARTICLE AU - Christiaan de Leeuw AU - Josefin Werme AU - Jeanne Savage AU - Wouter Peyrot AU - Danielle Posthuma TI - Reconsidering the validity of transcriptome-wide association studies AID - 10.1101/2021.08.15.456414 DP - 2021 Jan 01 TA - bioRxiv PG - 2021.08.15.456414 4099 - http://biorxiv.org/content/early/2021/08/15/2021.08.15.456414.short 4100 - http://biorxiv.org/content/early/2021/08/15/2021.08.15.456414.full AB - Transcriptome-wide association studies (TWAS)1–5, which aim to detect relationships between gene expression and a phenotype, are commonly used for secondary analysis of genome-wide association study (GWAS) results. Results of TWAS analyses are often interpreted as indicating a genetically mediated relationship between gene expression and the phenotype, but because the traditional TWAS framework does not model the uncertainty in the expression quantitative trait loci (eQTL) effect estimates6,7, this interpretation is not justified. In this study we outline the implications of this issue. Using simulations, we show severely inflated type 1 error rates for TWAS when evaluating a null hypothesis of no genetic relationship between gene expression and the phenotype. Moreover, in our application to real data only 51% of the TWAS associations were confirmed with local genetic correlation8 analysis, an approach which correctly evaluates the same null. Our results thus demonstrate that TWAS is unsuitable for investigating genetic relationships between gene expression and a phenotype.Competing Interest StatementThe authors have declared no competing interest.