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There are two potential issues that arise in observational studies that prevent you from ascribing cause-and-effect: confounding factors, also known as lurker variables, and reverse causation
[20] Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A
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Circulating selenium concentration is inversely associated with the prevalence of stroke: results from the Canadian Health Measures Survey and the National Health and Nutrition Examination Survey
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A FOOD SUPPLEMENT HAS NO MEDICINAL PROPERTIES.
The authors suggest that this is a steric effect
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