Bidirectional causal inference for binary outcomes in the presence of unmeasured confounding

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Hauptverfasser: Deng, Yafang, Shuai, Kang, Luo, Shanshan
Format: Preprint
Veröffentlicht: 2026
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author Deng, Yafang
Shuai, Kang
Luo, Shanshan
author_facet Deng, Yafang
Shuai, Kang
Luo, Shanshan
contents Bidirectional causal relationships arising from mutual interactions between variables are commonly observed within biomedical, econometrical, and social science contexts. When such relationships are further complicated by unobserved factors, identifying causal effects in both directions becomes especially challenging. For continuous variables, methods that utilize two instrumental variables from both directions have been proposed to explore bidirectional causal effects in linear models. However, the existing techniques are not applicable when the key variables of interest are binary. To address these issues, we propose a structural equation modeling approach that links observed binary variables to continuous latent variables through a constrained mapping. We further establish identification results for bidirectional causal effects using a pair of instrumental variables. Additionally, we develop an estimation method for the corresponding causal parameters. We also conduct sensitivity analysis under scenarios where certain identification conditions are violated. Finally, we apply our approach to investigate the bidirectional causal relationship between heart disease and diabetes, demonstrating its practical utility in biomedical research.
format Preprint
id arxiv_https___arxiv_org_abs_2601_17695
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Bidirectional causal inference for binary outcomes in the presence of unmeasured confounding
Deng, Yafang
Shuai, Kang
Luo, Shanshan
Methodology
Bidirectional causal relationships arising from mutual interactions between variables are commonly observed within biomedical, econometrical, and social science contexts. When such relationships are further complicated by unobserved factors, identifying causal effects in both directions becomes especially challenging. For continuous variables, methods that utilize two instrumental variables from both directions have been proposed to explore bidirectional causal effects in linear models. However, the existing techniques are not applicable when the key variables of interest are binary. To address these issues, we propose a structural equation modeling approach that links observed binary variables to continuous latent variables through a constrained mapping. We further establish identification results for bidirectional causal effects using a pair of instrumental variables. Additionally, we develop an estimation method for the corresponding causal parameters. We also conduct sensitivity analysis under scenarios where certain identification conditions are violated. Finally, we apply our approach to investigate the bidirectional causal relationship between heart disease and diabetes, demonstrating its practical utility in biomedical research.
title Bidirectional causal inference for binary outcomes in the presence of unmeasured confounding
topic Methodology
url https://arxiv.org/abs/2601.17695