{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T08:36:38Z","timestamp":1782549398355,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>We sought to establish normative peak expiratory flow (PEF) data for patients with idiopathic subglottic stenosis (iSGS), evaluate whether immediate changes in PEF after a procedure predict long\u2010term treatment response, and test if a decline in longitudinal PEF is associated with disease recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>International, prospective, 3\u2010year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>iSGS patients consented and enrolled in the North American Airway Collaborative (NoAAC) iSGS<jats:sup>1000<\/jats:sup> cohort recorded PEF data on a mobile smartphone app. Cox regression tested the associations between the magnitude of postoperative PEF improvement and longitudinal 90\u2010day PEF decline with the risk of disease recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within the NoAAC iSGS<jats:sup>1000<\/jats:sup> cohort, 810 patients participated in a 3\u2010year prospective study comparing surgical treatment efficacy and 385 had appropriate PEF measurements and follow\u2010up data. Of those patients, 42% (161\/385) required at least one operation during study follow\u2010up. The mean PEF preceding operative intervention was 241\u2009L\/min (95% confidence interval [CI]: 120\u2013380) corresponding to a predicted PEF of 52%. The mean increase in PEF following a procedure was 111\u2009L\/min (95% CI: 96\u2013125\u2009L\/min). Interestingly, the magnitude of immediate PEF improvement was not predictive of disease recurrence (hazard ratio [HR] for 100\u2009L\/min increase\u00a0=\u00a00.90, 95% CI: 0.60\u20131.00). However, recurrence was associated with the magnitude of PEF decline over 90\u2009days (30% vs. 10% decline, HR\u00a0=\u00a02.2, 95% CI: 1.5\u20133.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide normative PEF data on a large iSGS patient cohort. The degree of PEF improvement immediately after surgery was not associated with a longer procedure\u2010free interval. However, a 30% decline in PEF over 90\u2009days was associated with elevated risk of disease recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 131:E2841\u2013E2848, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29760","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T11:25:10Z","timestamp":1627298710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Modeling Recurrence in Idiopathic Subglottic Stenosis With Mobile Peak Expiratory Flow"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9947-9626","authenticated-orcid":false,"given":"Kyle","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Du","sequence":"additional","affiliation":[{"name":"Vanderbilt Center for Quantitative Sciences Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn D.","family":"Berry","sequence":"additional","affiliation":[{"name":"Vanderbilt Center for Quantitative Sciences Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Ching","family":"Huang","sequence":"additional","affiliation":[{"name":"Vanderbilt Center for Quantitative Sciences Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheau\u2010Chiann","family":"Chen","sequence":"additional","affiliation":[{"name":"Vanderbilt Center for Quantitative Sciences Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Francis","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin\u2010Madison  Madison Wisconsin U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0078-1305","authenticated-orcid":false,"given":"Alexander","family":"Gelbard","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"North American Airway Collaborative (NoAAC)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26098"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818803584"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.03.129"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24641"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.3022"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8873"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12858"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.2165"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28678"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28337"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.2717"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022243"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26930"},{"key":"e_1_2_6_15_1","unstructured":"Vanderbilt University. Airflo (Apple Inc).2019. Apple Inc. Copyright 2015. Available at:https:\/\/apps.apple.com\/us\/app\/airflo\/id1032827896"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6680.1068"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01063.2006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27006"},{"key":"e_1_2_6_19_1","unstructured":"Office of the National Coordinator for Health Information Technology.Conceptualizing a data infrastructure for the capture use and sharing of patient\u2010generated health data in care delivery and research through 2024. Available at:https:\/\/www.healthit.gov\/sites\/default\/files\/pghd_white_paper_final_formatted_by_onc_508_11-29-17.pdf. 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