{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:43:46Z","timestamp":1788284626909,"version":"build-2803163510"},"reference-count":41,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Identify factors associated with delayed diagnosis of sagittal craniosynostosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single institution tertiary care center over 10 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Ninety-one patients diagnosed with sagittal craniosynostosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Variables collected included sex, race, ethnicity, age at diagnosis, insurance type, distance traveled, community designation and Area Deprivation Index (ADI), cephalic index (CI), and prematurity (birth at gestational age\u2009&lt;\u200937 weeks). Statistical analysis was performed using Fisher exact test, Wilcoxon-sum test, and multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Main Outcome Measure(s):<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Age at diagnosis and factors associated with delayed diagnosis (&gt;6 months of age).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On univariable analysis, diagnosis &gt;6 months of age was associated with a greater proportion of non-Hispanic black patients (44% vs 8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and a smaller proportion of non-Hispanic white patients (39% vs 79%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). A greater proportion of patients had CI\u2009\u2265\u200975 (55% vs 6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and a greater proportion of patients had public insurance (68% vs 38%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008). On multivariable logistic regression non-Hispanic black patients were nearly 7 times more likely compared to non-Hispanic white patients to experience delayed diagnosis when controlling for national (OR 6.96,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.018) or state ADI (OR 6.51,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After adjusting for multiple clinical and sociodemographic factors including insurance type and CI, black patients were nearly 7 times more likely than white patients to experience delayed diagnosis of sagittal craniosynostosis. Future studies are needed to identify modifiable factors contributing to this diagnosis gap and identify opportunities to close it.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251344384","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:19:13Z","timestamp":1748402353000},"page":"1645-1652","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Race Is Associated With Delayed Diagnosis of Sagittal Craniosynostosis: A Single-Institutional Retrospective Study"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-4963","authenticated-orcid":false,"given":"Maura","family":"Guyler","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Doh","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klarens","family":"Menage","sequence":"additional","affiliation":[{"name":"Northeastern Ohio Medical University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Rothstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University Hospitals Rainbow Babies and Children's Hospital \/ Case Western Reserve School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystal L.","family":"Tomei","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University Hospitals Rainbow Babies and Children's Hospital \/ Case Western Reserve School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard D.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Plastic and Reconstructive Surgery, University Hospitals Rainbow Babies and Children's Hospital \/ Case Western Reserve School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.7.PEDS18585"},{"key":"e_1_3_2_3_2","first-page":"1","volume-title":"StatPearls","author":"Betances EM","year":"2023","unstructured":"Betances EM, Mendez MD, Das JM. 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