The observational nature of the study precludes conclusions regarding causality. Support for directionality was bolstered by the use of discrete-time survival models based on self-reported ages of onset to determine temporally prior TE exposure and other time-varying characteristics, such as marital status. Nevertheless, associations may have been due to some third, unmeasured, common cause. Furthermore, due to the number of multiple comparisons we focus on overall patterns and suggest caution when interpreting individual associations.
