{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:17Z","timestamp":1786977857528,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Technology and internet access have become increasingly integrated into healthcare as the primary platform for health\u2010related information and provider\u2010patient communication. Disparities in access to digital resources exist in the United States and have been shown to impact health outcomes in various head and neck malignancies. Our objective is to evaluate the associations of digital inequity on health outcomes in patients with salivary gland cancer (SGC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Digital Inequity Index (DII) was developed using 17 census\u2010tract level variables obtained from the American Community Survey and Federal Communications Commission. Variables were categorized as digital infrastructure or sociodemographic (e.g., non\u2010digital) and scored based on relative rankings across all US counties. Scores were assigned to patients from the Surveillance\u2010Epidemiology\u2010End Results (SEER) database diagnosed with SGC between 2013 and 2017 based on county\u2010of\u2010residence. Regressions were performed between DII score and outcomes of surveillance time, survival time, tumor stage at time of diagnosis, and treatment modality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 9306 SGC\u2010patients, increased digital inequity was associated with advanced\u2010staging at presentation (OR: 1.04, 95% CI: 1.01\u20131.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033), increased odds of chemotherapy receipt (OR: 1.05, CI: 1.01\u20131.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), and decreased odds of surgical intervention (OR: 0.94, 95% CI: 0.91\u20130.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) after accounting for traditional sociodemographic factors. Increased digital inequity was also associated with decreased surveillance time and survival periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Digital inequity significantly and independently associates with negative health and treatment outcomes in SGC patients, highlighting the importance of directed efforts to address these seldom\u2010investigated drivers of health disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.27930","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T01:10:37Z","timestamp":1727313037000},"page":"538-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of digital inequities on salivary gland cancer disparities in the United States"],"prefix":"10.1002","volume":"47","author":[{"given":"David M.","family":"Bruss","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Illinois at Chicago \u2013 College of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4485-8274","authenticated-orcid":false,"given":"David J.","family":"Fei\u2010Zhang","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Kim","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Chelius","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Sheyn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Le Bonheur Children's Hospital  Memphis Tennessee USA"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Tennessee Health Science Center  Memphis Tennessee USA"},{"name":"Department of Pediatric Otolaryngology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Maddalozzo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Division of Pediatric Otolaryngology Ann &amp; Robert H. Lurie Children's Hospital of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Rastatter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Division of Pediatric Otolaryngology Ann &amp; Robert H. Lurie Children's Hospital of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill N.","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Sciences Center Department of Otolaryngology  New Orleans Louisiana USA"},{"name":"Division of Pediatric Otolaryngology Children's Hospital of New Orleans  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131709600319"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010030\u201027828\u20101_16"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/4909214"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.102307"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1022255800411"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26633"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010020\u201000913\u20108"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26345"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X211018612"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27257"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15235522"},{"key":"e_1_2_9_13_1","unstructured":"Digital Divide Index.https:\/\/pcrd.purdue.edu\/ruralindianastats\/broadband\/ddi.php?variable=ddi-overview&county=Adams"},{"key":"e_1_2_9_14_1","unstructured":"Federal Communications Commission (FCC) Connect2Health Broadband Map.https:\/\/www.fcc.gov\/reports\u2010research\/maps\/connect2health\/map.html#ll=31.5 \u201096.4&z=4&t=insights&hmt=opioid&inb=in_bb_in_adoption&slb=0 84&inc=none&dmf=none&ino=in_alldrugs_age_adj_mortality_rate&slo=20.1 126.3&zlt=county"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2023.104066"},{"key":"e_1_2_9_16_1","unstructured":"Geographic Levels.https:\/\/www.census.gov\/programs\u2010surveys\/economic\u2010census\/guidance\u2010geographies\/levels.html#par_textimage_34"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30832"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26931"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1586\/era.12.92"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2015.1018590"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5105"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2006.11.004"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2022.76"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882\u2010022\u201001026\u20101"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/MSJ"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.2716.Association"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010011\u20100179\u20105"},{"key":"e_1_2_9_28_1","unstructured":"World Health Organization.Global diffusion of EHealth: making universal health coverage achievable. Report of the third global survey on EHealth; 2016.http:\/\/www.who.int\/goe\/publications\/global_diffusion\/en\/%0Ahttps:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/252529\/9789241511780\u2010eng.pdf;jsessionid=A51DD92196A091923303578718987E7F?sequence=1"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2010.006015"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2022.04.002"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.27930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T23:37:11Z","timestamp":1736465831000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.27930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,25]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/hed.27930"],"URL":"https:\/\/doi.org\/10.1002\/hed.27930","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,25]]},"assertion":[{"value":"2024-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}