{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:38:17Z","timestamp":1787978297845,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Limited data exist on long\u2010term outcomes associated with postural orthostatic tachycardia syndrome (POTS). We designed an online questionnaire to assess outcomes for patients formerly managed in a single\u2010center pediatric POTS program. Here, we report the educational, economic, and social long\u2010term impacts of pediatric POTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In part, the Long\u2010Term POTS Outcomes Survey (LT\u2010POTS) sought to evaluate education, employment, and social impact of POTS. Patients aged \u226418\u2009years at the time of POTS diagnosis were included. The survey was emailed to patients diagnosed or managed in the Children\u2019s Hospital of Philadelphia POTS Program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of 862 patients surveyed, 227 returned questionnaires with enough data for interpretation. Respondents were predominantly women (85%) and White individuals (97%). Half of patients missed &gt;100\u2009days of school, and 20% temporarily dropped out of school. More than 90% of patients graduated high school, and &lt;50% graduated college. Only 26% of patients were able to work &gt;40 hours\/week, with 35% having reduced hours due to POTS symptoms. Significant loss of income and financial expenditures were associated with POTS. Loss of social relationships and inability to live independently were additional associated social impacts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">POTS is a long\u2010term disorder associated with significant physical disability as well as adverse educational, economic, and social impacts. Although certain accommodations may mitigate the impact of the disease on education and employment, POTS poses significant educational, economic, and socioemotional risks, requiring further understanding of its pathophysiology and optimization of its management to reduce individual and societal impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042365","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:49:16Z","timestamp":1761648556000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010Term Postural Orthostatic Tachycardia Syndrome Outcomes Survey: Educational, Economic, and Social Impact"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0428-7681","authenticated-orcid":false,"given":"Jeffrey R.","family":"Boris","sequence":"first","affiliation":[{"name":"Jeffrey R. Boris, MD LLC","place":["Moylan, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3944-5835","authenticated-orcid":false,"suffix":"III","given":"Edward C.","family":"Shadiack","sequence":"additional","affiliation":[{"name":"War Related Illness and Injury Study Center, VA New Jersey Healthcare System","place":["East Orange, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2458-6889","authenticated-orcid":false,"given":"Laura","family":"MacMullen","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0237-7883","authenticated-orcid":false,"given":"Ibrahim","family":"George\u2010Sankoh","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1723-6728","authenticated-orcid":false,"given":"Marni J.","family":"Falk","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(82)90559-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4065\/74.11.1106"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.02.020"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0155-1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.02.035"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.14253\/acn.2019.21.1.30"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00261"},{"key":"e_1_3_2_9_2","unstructured":"Dysautonomia International . Vanderbilt University and Dysautonomia International launch \u201cThe Big POTS Survey\u201d to study the impact of postural tachycardia syndrome. Accessed October 11 2023. https:\/\/dysautonomiainternational.org\/page.php?ID=48."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_2_11_2","unstructured":"Social Science Statistics . Statistics calculators. Accessed October 11 2023. https:\/\/www.socscistatistics.com\/tests\/."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.033485"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2021.102828"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951117002888"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12895"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.07.016"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2010.12.001"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2013.12.014"},{"key":"e_1_3_2_19_2","unstructured":"Think Impact . High school statistics 2025. Accessed October 11 2023. https:\/\/www.thinkimpact.com\/high\u2010school\u2010statistics."},{"key":"e_1_3_2_20_2","volume-title":"The price we pay: economic and social consequences of inadequate education","author":"Belfield CR","year":"2007","unstructured":"Belfield CR, Levin HM. The price we pay: economic and social consequences of inadequate education. Washington, DC: Brookings Institution Press; 2007."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.03.031"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000701"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.88.4.610"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-1561.2003.tb03585.x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssresearch.2014.08.013"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-019-01110-2"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17217836"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2021.08.014"},{"key":"e_1_3_2_29_2","volume-title":"Out\u2010of\u2010pocket expenditures for adults with health care expenses for multiple chronic conditions, U.S. Civilian Noninstitutionalized Population, 2014 (STATISTICAL BRIEF #498)","author":"Soni A","year":"2017","unstructured":"Soni A. Out\u2010of\u2010pocket expenditures for adults with health care expenses for multiple chronic conditions, U.S. Civilian Noninstitutionalized Population, 2014 (STATISTICAL BRIEF #498). Rockville, MD: Agency for Healthcare Research and Quality (US); 2017."},{"key":"e_1_3_2_30_2","volume-title":"Concentration of healthcare expenditures and selected characteristics of persons with high expenses, U.S. Civilian Noninstitutionalized Population, 2018","author":"Mitchell EM","year":"2021","unstructured":"Mitchell EM. Concentration of healthcare expenditures and selected characteristics of persons with high expenses, U.S. Civilian Noninstitutionalized Population, 2018. Rockville, MD: Agency for Healthcare Research and Quality (US); 2021."},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.01763"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2011.02.004"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-019-00622-y"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2000.tb06760.x"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.042365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:22:24Z","timestamp":1780485744000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.042365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":33,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2025,11,4]]}},"alternative-id":["10.1161\/JAHA.125.042365"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.042365","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"assertion":[{"value":"2025-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e042365"}}