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. 2020 Feb 23;5(2):e001729. doi: 10.1136/bmjgh-2019-001729

Figure 1.

Figure 1

Causal diagram. This diagram explains the identification assumptions under the two-stage least squares method. I assume that, conditional on X, Z is a valid instrument if 1) Z is strongly correlated with S (relevance), 2) Z is not associated with U and 3) Z affects Y only through its effects on S (exclusion restriction). Under an additional assumption, 4) Z changes S only in one direction (monotonicity), the estimated treatment effects are interpreted as local average treatment effects.