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Explore the evolution and significance of Mendelian randomization (MR) in this comprehensive lecture by George Davey Smith. Delve into the historical context of genetics and phenotypic causation, tracing its roots back to the 1850s. Understand how MR utilizes germline genetic variation to establish relationships between exposure and outcome phenotypes. Examine the exponential growth of MR studies and the expanding availability of relevant data. Learn about the crucial assumption of gene-environmental equivalence in making inferences on phenotypic causality in both evolutionary and epidemiological settings. Review the development of MR since 2003, including its capabilities and limitations. Gain insights into potential future directions of MR research and how it might evolve by 2043. Benefit from the speaker's extensive experience in epidemiology and his role in formalizing the current understanding of Mendelian randomization.