PDE5A and actinic keratosis: Given the lack of any direct data on sun and UV exposure, we made use of data on other outcomes known to be related to sun exposure to assess the likely impact of residual confounding: we investigated basal cell carcinoma and solar keratosis as negative control outcomes, and we looked at differences in prior solar keratosis between exposed and unexposed patients to investigate whether sun exposure might be associated with prescription of a PDE5 inhibitor.