To the Editor,We would like to commend the authors, Ziltzer et al., on their insightful and important work titled "Role of Social Determinants of Health on Quality of Life in Pediatric Chronic Rhinosinusitis," published in the International Forum of Allergy & Rhinologyudy, 1 which addresses a critical gap in our understanding of how socioeconomic factors influence health-related quality of life in pediatric patients, an area that has not been extensively explored. However, we would like to offer some constructive feedback that may help refine the interpretations of the results and suggest areas for future research.First, from a statistical standpoint, the authors have done well in choosing a robust model to analyze the data. However, the data collection period spanned from August 2020 to June 2023, a time during which external factors, notably the COVID-19 pandemic, may have impacted the quality of life for patients. 2,3 Second, the study appropriately controlled for several confounding factors, such as age, adenoid size, asthma history, and allergic rhinitis history, which is commendable. However, we also consider that family support may influence the quality of life of affected children. 4 For pediatric patients, family support can directly impact the choice of medical treatment options, and different treatment approaches may lead to varying outcomes in terms of their quality of life. Considering these variables in future research would likely enhance our understanding of the complex relationship between social determinants and pediatric chronic rhinosinusitis.Improving the quality of life of patients, particularly in underdeveloped regions, necessitates a more integrated and patient-centered approach. 5 This approach should begin with a shift from the traditional treatment-focused medical model to one that emphasizes continuous care and support for patients beyond the initial treatment phase. In these regions, it is crucial to strengthen the collaboration between hospitals and community healthcare providers, enabling a seamless follow-up and management system through primary care services. By focusing on communitylevel health interventions, healthcare professionals can better address the social determinants that negatively
