JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Patient-Reported Quality of Life and Socioeconomic Disadvantage Among Patients With Head and Neck Cancer.","authors":"Kyle Leonard, Samantha Tam, Amy M Williams, Kylie Springer, Kimberly Oslin, Veronica Bernacchi, Tamer A Ghanem, Steven S Chang, Suhael Momin, Farzan Siddiqui, Eric Adjei Boakye","doi":"10.1001/jamaoto.2026.1268","DOIUrl":"10.1001/jamaoto.2026.1268","url":null,"abstract":"<p><strong>Importance: </strong>Lower socioeconomic status is a risk factor for poorer quality of life (QOL) among patients with head and neck cancer (HNC) after treatment; however, there is a paucity of literature describing baseline QOL in these patients, with much of the existing literature focused on financial characteristics rather than comprehensive, geographically based factors. Shifting focus to these factors could better capture the entire patient experience and allow clinicians to provide improved care.</p><p><strong>Objective: </strong>To examine the associations between area-level deprivation, a marker of socioeconomic disadvantage, and QOL among patients with HNC before treatment initiation.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional single-institution study included patients diagnosed with HNC between 2015 and 2022 receiving care at a tertiary care center in a metropolitan setting who completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) questionnaire before starting treatment. Data were analyzed between December 2024 and May 2025.</p><p><strong>Exposure: </strong>Area-level deprivation (measured using the area deprivation index [ADI]), as designated by the patient's respective ADI quintile, with the first quintile being the least deprived or socioeconomically disadvantaged and the fifth quintile being the most deprived or disadvantaged.</p><p><strong>Main outcomes and measures: </strong>FACT-HN domains of social, emotional, functional, physical, HNC-specific, and overall well-being or QOL. Multivariable linear regression models (1 for each domain) were used to estimate associations between ADI quintiles and FACT-HN domains, adjusting for patient and clinical characteristics.</p><p><strong>Results: </strong>A total of 600 patients (mean [SD] age, 62.5 [11.4] years; 72.3% males [n = 434]) were included in the analysis. The ADI quintiles were equally distributed, with approximately 20% of patients in each quintile. Patients residing in the most disadvantaged areas reported lower HNC-specific well-being scores (β = -3.62; 95% CI, -6.23 to -1.01) compared with those residing in the least disadvantaged areas. Associations between ADI quintile and other well-being scores were weak and not clinically meaningful.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study, greater socioeconomic disadvantage is associated with poorer baseline QOL among patients diagnosed with HNC. These findings could be used to identify patients at higher risk of lower QOL and support the equitable allocation of resources from multidisciplinary cancer care teams.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"744-752"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Manganese and Risk of Squamous Cell Carcinomas of the Head and Neck.","authors":"Benjamin Clay, Nasir Bashir, Stephen Burgess, Paul Carter","doi":"10.1001/jamaoto.2026.1749","DOIUrl":"10.1001/jamaoto.2026.1749","url":null,"abstract":"<p><strong>Importance: </strong>Squamous cell carcinomas of the oral cavity (OCSCC), oropharynx (OPSCC), hypopharynx (HPSCC), and larynx (LSCC) are the most common forms of head and neck cancer globally. Epidemiological studies have identified variations in blood trace metal concentrations as potential risk factors for the development of these cancers, but these studies are susceptible to multiple biases.</p><p><strong>Objective: </strong>To determine if variations in genetically predicted blood manganese are associated with risk of OCSCC, OPSCC, HPSCC, and LSCC.</p><p><strong>Design, setting, and participants: </strong>This population-based 2-sample cis-mendelian randomization study used a genetic instrument for blood manganese derived from a meta-analysis of 3 individual-level genome-wide association study datasets of 6564 Scandinavian participants. Genetic associations for the development of the specified cancers were obtained from a nonoverlapping, multi-ancestral meta-analysis that combined individual-level genome-wide association study datasets comprising 38 857 healthy controls, 5596 case patients with OCSCC, 2212 case patients with human papillomavirus (HPV)-positive OPSCC, 1473 case patients with HPV-negative OPSCC, 898 case patients with HPSCC, and 4409 case patients with LSCC.</p><p><strong>Exposures: </strong>Increases in genetically predicted whole blood manganese concentration proxied by a genetic instrument including 2 cis-variants (single-nucleotide variants) selected due to their known functions in regulating manganese metabolism.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were the risk of OCSCC, OPSCC (HPV positive and HPV negative), HPSCC, and LSCC, evaluated by estimating the odds ratio (OR) and 95% CI of each outcome per 1-SD increase in whole blood manganese concentration after rank-based inverse normalization transformation.</p><p><strong>Results: </strong>Genetically predicted higher blood manganese was found to have a statistically significant association with increased risk of OCSCC (OR, 1.25; 95% CI, 1.10-1.43; P < .001) and HPV-positive OPSCC (OR, 1.23; 95% CI, 1.04-1.45; P = .02). Associations between blood manganese and HPV-negative OPSCC (OR, 1.20; 95% CI, 0.95-1.50; P = .13), HPSCC (OR, 1.25; 95% CI, 0.75-2.07; P = .39), and LSCC (OR, 1.10; 95% CI, 0.92-1.32; P = .28) were directionally concordant but not statistically significant.</p><p><strong>Conclusions and relevance: </strong>This cis-mendelian randomization study demonstrates statistically significant associations between higher blood manganese concentrations and risk of OCSCC and HPV-positive OPSCC. Further work should aim to establish the pathophysiological mechanisms underlying this association to inform potential public health strategies for the prevention of these cancers.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"791-796"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Diet and Lifestyle Program With 3 Medication Approaches for Laryngopharyngeal Reflux Disease Management.","authors":"Jerome R Lechien","doi":"10.1001/jamaoto.2026.0577","DOIUrl":"10.1001/jamaoto.2026.0577","url":null,"abstract":"<p><strong>Importance: </strong>There are no studies comparing the primary therapeutic options for laryngopharyngeal reflux disease (LPRD).</p><p><strong>Objective: </strong>To compare the effectiveness of antireflux diet and 3 medication classes in patients with LPRD.</p><p><strong>Design, setting, and participants: </strong>This is a retrospective analysis of consecutive patients with LPRD who were prospectively recruited from April 2018 to February 2024 from 2 medical hospitals in Belgium and France. Data were analyzed in November 2025.</p><p><strong>Exposures: </strong>Strict antireflux diet and stress reduction activities, alginates, magaldrates, or proton pump inhibitors.</p><p><strong>Main outcomes and measures: </strong>Age, sex, pretreatment to posttreatment reflux symptom score (RSS), and reflux sign assessment (RSA) were prospectively collected in patients with an objective LPRD diagnosis at the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing. The pretreatment to posttreatment clinical features (RSS, RSA, and therapeutic response rates) were compared across patient groups regarding treatment regimens.</p><p><strong>Results: </strong>Of 145 included patients, 84 (57.9%) were female, and the median (IQR) age was 53 (37.0-63.3) years. Patients treated with proton pump inhibitors (n = 32), antacids (n = 27), alginates (n = 38), and strict diet (n = 48) were comparable for median age, sex proportions, and baseline RSS and RSA. RSS and RSA demonstrated significant reduction in all groups. Linear mixed model analysis revealed a significant main effect of time on both RSS (F1,274 = 19.82; P < .001) and RSA (F1,219 = 26.47; P < .001), confirming symptom and sign improvement across all groups. For RSS, treatment group was significantly associated with RSS scores (F3,274 = 3.53; P = .02). The diet group had significantly lower estimated marginal mean RSS scores than the antacid group (mean difference, 38.73; 95% CI, 4.24-73.23). The change in RSS scores over time did not differ between groups. For RSA, neither the group effect nor the interaction reached significance. The diet group had the highest proportion of responders (diet, 39 of 48 [81.2%]; proton pump inhibitor, 18 of 32 [56.3%]; alginates, 22 of 38 [57.9%]; antacids, 20 of 27 [74.1%]), with proportion differences of 24.9 percentage points (95% CI, 4.6-45.4) compared with proton pump inhibitors, 23.4 percentage points (95% CI, 4.2-42.5) compared with alginates, and 7.2 percentage points (95% CI, -12.7 to 27.1) compared with antacids.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, adherence to an antireflux diet and stress-reduction activities may be associated with comparable or greater symptom relief at 3 months posttreatment compared with conventional medical therapies. Randomized clinical trials comparing the 4 regimens are needed.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"816-821"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Methodological and Clinical Reflections.","authors":"Sium Wolde Sellasie, Arnoldo Piccardo, Pierpaolo Trimboli","doi":"10.1001/jamaoto.2026.1409","DOIUrl":"10.1001/jamaoto.2026.1409","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"832"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Corticosteroids and Adverse Events in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Seojin Moon, Myeongjee Lee, Inkyung Jung, Min-Seok Rha","doi":"10.1001/jamaoto.2026.1188","DOIUrl":"10.1001/jamaoto.2026.1188","url":null,"abstract":"<p><strong>Importance: </strong>Oral corticosteroids are commonly used in the management of chronic rhinosinusitis with nasal polyps to control inflammation. However, evidence on the long-term safety of repeated or high-dose oral corticosteroid exposure in this population remains limited.</p><p><strong>Objective: </strong>To investigate the association between oral corticosteroid exposure and systemic adverse events in patients with chronic rhinosinusitis with nasal polyps.</p><p><strong>Design, setting, and participants: </strong>A retrospective, nationwide, nested case-control study included adult patients (≥20 years) with incident chronic rhinosinusitis with nasal polyps, excluding those with prior immune-mediated diseases or outcome diagnoses, using the Korean Health Insurance Review and Assessment Service database (2010-2023). Data analysis was conducted from March 2025 to April 2026. Patients who developed adverse events (case patients) were matched 1:10 with controls by age, sex, and diagnosis date.</p><p><strong>Exposures: </strong>Oral corticosteroid exposure was quantified using 3 metrics: exposure intensity (annual duration: low [≤30 days], moderate [31-90 days], or high [>90 days]), cumulative dose (<0.5 g, 0.5-1.0 g, or ≥1.0 g prednisolone-equivalents per year), and prescription frequency.</p><p><strong>Main outcomes and measures: </strong>First occurrence of systemic adverse events. Adjusted odds ratios and 95% CIs were estimated using multivariable conditional logistic regression.</p><p><strong>Results: </strong>A total of 165 361 patients with chronic rhinosinusitis with nasal polyps who were prescribed at least 1 oral corticosteroid were identified. The matched cohort included 523 316 patients (51 647 case patients and 472 369 controls; mean [SD] midpoint approximated age, 47.1 [13.9] years; 39.7% women). High exposure intensity (>90 days per year) was associated with a significantly increased risk of avascular bone necrosis, osteoporosis, and pneumonia. A cumulative dose greater than 1.0 g per year was associated with a 23% higher overall adverse event risk (adjusted odds ratio, 1.23; 95% CI, 1.11-1.36) and increased risks of avascular bone necrosis, pneumonia, dyslipidemia, heart failure, hypertension, and type 2 diabetes. Prescription frequency was not independently associated with adverse event risk.</p><p><strong>Conclusions and relevance: </strong>In this nested case-control study within a nationwide cohort of patients with chronic rhinosinusitis with nasal polyps, higher oral corticosteroid exposure, in terms of annual duration and cumulative dose, was associated with an increased risk of systemic adverse events, particularly musculoskeletal and infection-related complications. These findings underscore the need for steroid-sparing treatment strategies for long-term management of chronic rhinosinusitis with nasal polyps.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"735-743"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Figure.","authors":"","doi":"10.1001/jamaoto.2026.1245","DOIUrl":"10.1001/jamaoto.2026.1245","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"729"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Application as a Digital Therapeutic for Chronic Tinnitus: A Randomized Clinical Trial.","authors":"Koichiro Wasano, Taiji Kawasaki, Fumiyuki Goto, Yoshihiko Hiraga, Shinji Nagai, Madoka Tominaga, Kaoru Ogawa","doi":"10.1001/jamaoto.2026.0858","DOIUrl":"10.1001/jamaoto.2026.0858","url":null,"abstract":"<p><strong>Importance: </strong>Tinnitus is a highly prevalent condition that has no cure and can severely impair quality of life. Patients who receive cognitive behavioral therapy (CBT) and hearing aid therapy for chronic tinnitus accompanied by hearing loss have shown some improvement, but access to these interventions is limited.</p><p><strong>Objective: </strong>To develop a prototype digital therapeutic mobile app that provides educational counseling and CBT elements for treating chronic tinnitus symptoms and test its efficacy and safety for 16 weeks in patients reporting distressing chronic tinnitus.</p><p><strong>Design, setting, and participants: </strong>This double-blind, sham-controlled randomized clinical trial was conducted from September 2023 to February 2025 in individuals diagnosed with mild to severe chronic tinnitus. The trial included a 16-week treatment phase followed by an 8-week follow-up phase. Data were analyzed from February to March 2025.</p><p><strong>Intervention: </strong>Participants used either the therapeutic app or a sham control app that lacked the therapeutic functions. During the 8-week follow-up, the app's therapeutic functions were blocked and only the app's recording function was available.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was change from baseline to week 16 in the Tinnitus Handicap Inventory (THI) score, an index of tinnitus-related distress and functional impairment. Secondary outcomes were patient-reported and included THI, Tinnitus Functional Index, tinnitus loudness and control numeric rating scales, Hospital Anxiety and Depression Scale, Athens Insomnia Scale, and Patient Global Impression of Improvement.</p><p><strong>Results: </strong>A total of 60 participants (33 [55%] female; median [IQR] age, 58.5 [52.0-64.0] years) were assessed, including 30 participants in the therapeutic app group and 30 participants in the sham-control app group. The overall mean (SD) baseline THI was 41.3 (16.9). At week 16, the therapeutic app group showed significantly greater improvement in THI scores compared with the sham-control app group (between-group difference in change in THI, -20.4; 95% CI, -28.2 to -12.6). The therapeutic effect was maintained up to week 24 (mean between-group difference, -18.3; 95% CI, -26.4 to -10.1). Tinnitus worsened in 1 patient in the sham-control app group. No serious adverse events or device malfunctions with potential for health hazards were observed.</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that use of a tinnitus therapeutic app resulted in substantial and lasting improvement in tinnitus-related distress and functional impairment. The therapeutic app may serve as an effective and standardized intervention for individuals with chronic tinnitus.</p><p><strong>Trial registration: </strong>jrct.mhlw.go.jp Identifier: 032230359.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"677-685"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsideration of Methods and Outcomes.","authors":"Keyu Shen, Ping Duo, Xiequn Xu","doi":"10.1001/jamaoto.2026.0846","DOIUrl":"10.1001/jamaoto.2026.0846","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"724-725"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Anti-BNLF2b Antibody Screening and Early Detection of Nasopharyngeal Carcinoma.","authors":"Wan-Lun Hsu, Jiabao Tang, Hoi Yan Lam, Zhiwei Liu, W K Jacky Lam, Kwok Hung Chan, Yen-Liang Chang, Honglin Chen, Skye Hung-Chun Cheng, Yin-Chu Chien, Chu-Hsing Kate Hsiao, Chun-Hung Hua, Jehn-Chuan Lee, Yi-Shing Leu, Fugui Li, Li-Jen Liao, Ching-Yuan Lin, Jiayan Liu, Pei-Jen Lou, Shyuang-Der Terng, Ming-Hsui Tsai, Yung-An Tsou, Cheng-Ping Wang, Ming-Shiang Wu, Tsung-Lin Yang, Kelly J Yu, Xia Yu, K C Allen Chan, Allan Hildesheim, Tingdong Li, Mingfang Ji, Chien-Jen Chen","doi":"10.1001/jamaoto.2026.0838","DOIUrl":"10.1001/jamaoto.2026.0838","url":null,"abstract":"<p><strong>Importance: </strong>Tests for total antibodies specific to the Epstein-Barr virus (EBV) BNLF2b gene-encoded putative protein (P85-Ab) have shown high sensitivity and specificity for detecting newly diagnosed nasopharyngeal carcinoma (NPC). However, independent validation of these findings is important before considering clinical application.</p><p><strong>Objective: </strong>To compare the performance of P85-Ab testing for NPC detection with a combined Epstein-Barr virus-specific IgA antibody score and a circulating EBV DNA algorithm.</p><p><strong>Design, setting, and participants: </strong>This was a multicenter case-control study conducted from July 2010 to December 2014 at 6 medical centers in northern and central Taiwan. Participants were patients with NPC and controls who all provided blood samples for EBV biomarker testing. Data were analyzed from January 2025 to January 2026.</p><p><strong>Exposures: </strong>Total antibodies specific to P85-Ab. For comparison, EBV viral capsid antigen/nuclear antigen 1 (VCA-IgA/EBNA1-IgA) antibody score and the circulating EBV DNA algorithm results were evaluated from the same archived blood specimens collected at enrollment.</p><p><strong>Results: </strong>The analysis included 892 patients with NPC (mean [SD] age, 48.6 [11.1] years; 191 females [21.4%] and 701 males [78.6%]) and 1804 individuals in the control group (mean [SD] age, 48.1 [12.2] years; 542 females [30.0%] and 1262 males [70.0%]). P85-Ab demonstrated a sensitivity of 92.5% (95% CI, 90.7%-94.3%) and specificity of 98.7% (95% CI, 98.2%-99.2%), higher than the EBV VCA-IgA/EBNA1-IgA score (sensitivity, 88.4%; specificity, 94.9%) and comparable to the circulating EBV DNA algorithm (sensitivity, 93.2%; specificity, 98.1%). Sensitivity for early-stage NPC was higher for P85-Ab (93%) than for the other 2 methods (87%). P85-Ab performance remained high across age, sex, region, ethnicity, family history, and smoking subgroups. At NPC incidence rates of 20 to 100 per 100 000 person-years, the numbers needed to screen were similar across the 3 approaches: 5656 and 1131 for EBV VCA-IgA/EBNA1-IgA; 5365 and 1073 for EBV DNA; and 5405 and 1081 for P85-Ab. Positive predictive value (PPV) was 0.4% for the EBV antibody score, 1.0% for the EBV DNA algorithm, and 1.4% for the P85-Ab test; at an incidence of 100 per 100 000, the PPVs increased to 1.7%, 4.7%, and 6.6%, respectively.</p><p><strong>Conclusions and relevance: </strong>This multicenter case-control study found that P85-Ab testing had high sensitivity and specificity for early detection of NPC, with performance better than or comparable to existing EBV-based screening methods. These findings support the potential use of P85-Ab testing as a practical biomarker for population-based NPC screening.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"669-676"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an Adaptive Sinonasal Outcome Test.","authors":"Selena K Zhang, Sapideh Gilani, Ayako Stanlie, Jay F Piccirillo, Anthony Prince, Carleton Eduardo Corrales, Allen Zhou, Sana Alkhatib, Jennifer J Shin","doi":"10.1001/jamaoto.2026.1008","DOIUrl":"10.1001/jamaoto.2026.1008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The Sino-Nasal Outcome Test (SNOT) is used worldwide to assess chronic rhinosinusitis (CRS). An adaptive form of this instrument has established concordance between subjective patient-reported outcomes and objective imaging findings, but its broader psychometric properties have yet to be evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate whether the adaptive SNOT can function as a validated instrument.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This validation diagnostic study of internal consistency, reliability, responsiveness, and convergent and discriminant validity of an adaptive SNOT instrument included consecutive patients 15 years and older who prospectively completed the adaptive SNOT, including factor analysis on 1072 responses. Computed tomography (CT) imaging of the sinuses was performed in 70 patients. Data were collected from January 2024 to August 2025, and data were analyzed from August to September 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;CRS and allergy-related symptoms as well as secondary ear, sleep, psychological, and productivity domains were assessed through completion of the adaptive SNOT instrument. Lund-Mackay CT scores (LMCT) were calculated to measure objective disease severity in sinus imaging, while Patient-Reported Outcomes Measurement Information System scores were used to assess general health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Factor analysis and internal consistency were assessed. Adaptive SNOT scores in patients with LMCT scores less than 5 or 5 and greater were evaluated via differences in means and effect sizes. Convergent validity was evaluated with Spearman ρ. Intrarater reliability was evaluated with Cohen κ, Spearman ρ, and intraclass correlation coefficient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1072 included patients, 782 (72.9%) were female, and the mean (SD) age was 54 (21) years. The adaptive SNOT nasal domain and all-domain scores clearly distinguished between patients with LMCT scores of 5 and greater and those with LMCT scores less than 5 (nasal domain score: difference in means, 0.33; 95% CI, 0.03-0.63; Cohen d = 0.80; all-domain score: difference in means, 3.04; 95% CI, 0.02-6.05; Cohen d = 0.57). Adaptive SNOT scores also demonstrated associations with physical, mental, social, and global health (associations ranged from low to strong). Intrarater reliability was substantial for both the nasal domain alone (Cohen κ range, 0.72-0.74) and across all domains (Cohen κ range, 0.73-0.75). Additionally, the adaptive SNOT nasal and all-domain scores were responsive to change and improved among patients who received CRS treatment with medication or surgery from a mean score of 9.12 (95% CI, 6.37-11.87) to 2.47 (95% CI, 0.89-4.05) (Cohen d = 0.76).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Findings of this validation diagnostic study support the validation of the adaptive SNOT instrument for assessing CRS-related and allergic rhini","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"659-668"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}