{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:41:14Z","timestamp":1793742074457,"version":"4.6.1"},"reference-count":16,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"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":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microtia is a congenital anomaly characterized by malformation of the external ear. The complex chronic conditions (CCC) classification system identifies children with long-standing health problems based on various body systems and disease types. This study utilized the Pediatric Health Information System (PHIS) database to investigate the relationship between microtia and CCCs to guide screening protocols and provide insight into patient-centered treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of PHIS was conducted between 2015 and 2023. Patients were identified with an initial encounter with an associated microtia diagnosis from all participating hospitals. Patient demographics, associated organ system flags, and CCCs were collected and analyzed. Descriptive statistics were performed and effect sizes were calculated to assess associations between variables and microtia complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 20,313 patients with microtia were identified. Of these patients, 11\u2005183 were male (55.1%), non-Hispanic White (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20098089, 41.9%), or Hispanic (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20096512, 33.8%). Nearly 40% of diagnoses were associated with at least 1 CCC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20098234), and a significant proportion (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20095715) were noted to have 2 or more CCCs. Cardiovascular diagnoses were among the most common organ system affected (16.8%), followed by gastrointestinal conditions (15.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights a significant correlation between microtia and CCCs. With 40% of patients diagnosed with microtia also presenting with at least 1 CCC, this study underscores the importance of comprehensive medical assessment and care strategies while further supporting the increased correlation of cardiac conditions in this population. This necessitates a re-evaluation of first-line screening modalities for patients presenting with microtia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251355039","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T04:02:11Z","timestamp":1751342531000},"page":"1879-1884","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Relationship Between Microtia and Complex Chronic Conditions: A Comprehensive Analysis of 20\u2005000 Patients"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6312-5242","authenticated-orcid":false,"given":"Chizoba A","family":"Mosieri","sequence":"first","affiliation":[{"name":"Louisiana State University Health Science Center"},{"name":"University of California Irvine Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T","family":"Antongiovanni","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Washington State University Elson S. Floyd College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra","family":"Willens","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Shah","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Children's Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Alaniz","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Children's Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Blaine","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-0786","authenticated-orcid":false,"given":"Raj M","family":"Vyas","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Children's Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0086-2060","authenticated-orcid":false,"given":"Miles J","family":"Pfaff","sequence":"additional","affiliation":[{"name":"University of California Irvine Medical Center"},{"name":"Children's Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Human Malformations and Related Anomalies","author":"Stevenson RE","year":"1993","unstructured":"Stevenson RE, Hall JG, Goodman RM. Human Malformations and Related Anomalies. New York, NY: Oxford University Press; 1993."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005066"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35888"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.07.026"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.109957"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004885"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820901351"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110764"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-14-199"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0309692"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618799906"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.20579"},{"key":"e_1_3_3_14_2","unstructured":"Pediatric Microtia. no date. Children\u2019s National. Available at: https:\/\/www.childrensnational.org\/get-care\/health-library\/microtia (Accessed: 05 June 2025)."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20836"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110211"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007296"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251355039","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656251355039","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251355039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:16:35Z","timestamp":1781327795000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656251355039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/10556656251355039"],"URL":"https:\/\/doi.org\/10.1177\/10556656251355039","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}