{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:56:43Z","timestamp":1785416203278,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001422","name":"American Society of Hematology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001422","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcranial doppler (TCD) screening identifies children ages 2\u201316\u00a0years with sickle cell disease (SCD) at an increased risk for stroke. Previous studies have shown that individuals from households on public insurance with limited neighborhood opportunity have increased barriers to receiving adequate healthcare; however, it is unknown whether low socioeconomic status (SES) influences TCD results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of the DISPLACE study data, which included children aged 2\u20136\u00a0years who had at least one TCD screen performed during their year of study enrollment, if space allowed. We utilized insurance type (public insurance vs. all other insurances) and overall childhood opportunity index (COI) group (Very Low vs. all other COI levels [Low, Medium, High, and Very High]) to proxy household\u2010 and neighborhood\u2010level SES. We then examined the association between household\u2010 and neighborhood\u2010level SES and conditional or abnormal TCD screening results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analytic cohort included 3124 children, with 1295 (41.5%) children living in Very Low COI neighborhoods and 2019 (64.6%) of households with public insurance. In the multinomial logistic regression model, only the lack of HU prescription remained significantly associated at\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05 with abnormal TCD result (adjusted odds ratio = 19.01,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lack of hydroxyurea (HU) prescription was the factor most strongly associated with abnormal TCD outcome. Low SES proxies were not independently associated with abnormal or conditional TCD results. Qualitative studies are needed to better understand why a child with SCD might not have been prescribed HU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.32112","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:08:53Z","timestamp":1760418533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Socioeconomic Status and Stroke Risk in Pediatric Sickle Cell Disease: A DISPLACE Study Secondary Analysis"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-2880","authenticated-orcid":false,"given":"Jeffrey G.","family":"Edwards","sequence":"first","affiliation":[{"name":"Department of Medicine Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T.","family":"Humphrey","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Mueller","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5697-9156","authenticated-orcid":false,"given":"Shannon","family":"Phillips","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1106-5016","authenticated-orcid":false,"given":"Alyssa","family":"Schlenz","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Department of Pediatrics \u2010 Developmental Pediatrics University of Colorado School of Medicine Aurora Colorado 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Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-5872","authenticated-orcid":false,"given":"Natasha M.","family":"Archer","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Boston Children's Cancer and Blood Disorders Center  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000078894.79866.95"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25655"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.022"},{"key":"e_1_2_8_5_1","unstructured":"U.S. Census Bureau for Labor Statistics \u201cCurrent Population Survey Annual Social and Economic Supplement \u201dU.S. 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