Stephanie F. Wang

All Publications

• Physician-Reported Safety Outcomes of AI-Generated Hospital Course Summaries. JAMA network open Grolleau, F., Liang, A. S., Keyes, T., Ma, S. P., Lew, T., Huynh, T. R., Steele, N., Chung, P., Qin, P., Chandra, G., Wang, S. F., Mullen, E., Carpenter, L., Hoppenfeld, M., Morrin, M., Kyerematen, B. A., Ambers, N., Kotecha, N., Alsentzer, E., Hom, J., Shah, N. H., Schulman, K., Chen, J. H. 2026; 9 (5): e2616556

  Abstract

  High-quality discharge summaries are essential for safe care transitions but contribute substantially to clinician documentation burden and burnout. While retrospective studies suggest that large language models (LLMs) can generate clinical summaries of comparable quality to those by physicians, prospective data on their safety, utility, and association with clinician well-being in clinical environments are lacking.To evaluate the safety, use, and association with clinician burden of MedAgentBrief, an LLM-based agentic workflow for generating hospital course summaries, during prospective clinical deployment.This single-arm prospective pilot quality improvement study encompassed hospital discharges at 1 academic inpatient medicine unit from August 1 to October 11, 2025, with baseline comparisons drawn from April 9 to July 31, 2025.A custom agentic LLM workflow using Gemini 2.5 Pro generated draft hospital course summaries nightly using patient history and physical and daily progress notes. Drafts were securely emailed to physicians daily for review and optional use.The primary outcome was physician-reported potential for and severity of harm from unedited summaries (Agency for Healthcare Research and Quality Common Format Harm Scale). Secondary outcomes included use rate, error types (omissions, inaccuracies, and hallucinations), time spent in discharge summaries (electronic health record logs), and changes in cognitive burden (NASA Task Load Index; score range, 0-100, with higher scores indicating greater cognitive burden) and burnout (Stanford Professional Fulfillment Index Work Exhaustion Scale; score range, 0-4, with higher scores indicating greater burnout).Among 384 hospital discharges, the system generated 1274 summaries. Physicians used artificial intelligence (AI) content in 219 cases (57.0%). Feedback on 100 summaries (88 of 219 used summaries [40.2%] and 12 of 165 unused summaries [7.3%]) noted omissions (25 summaries [25.0%]) and inaccuracies (20 summaries [20.0%]) but rare hallucinations (2 summaries [2.0%]). Physicians rated 88 unedited summaries (88.0%) as having no harm potential and 1 (1.0%) as likely to cause moderate harm; no severe harm was reported. Mean physician burnout scores decreased significantly from before to after the intervention (1.75; 95% CI, 1.16-2.34 vs 1.20; 95% CI, 0.71-1.69; P = .03). Time savings were heterogeneous, with 5 of 7 physicians with matched baseline data (71.4%) seeing reductions in median documentation time; changes from baseline to pilot were up to 2.9 minutes, which was a nonsignificant difference (10.7 minutes; 95% CI, 7.4-13.3 minutes vs 7.8 minutes; 95% CI, 5.1-11.7 minutes; P = .13).In this study, an LLM-based agentic workflow produced hospital course summaries that were frequently used with minimal risk of harm identified. The intervention was associated with a reduction in physician burnout, supporting the viability of AI summarization to mitigate documentation burden.

  View details for DOI 10.1001/jamanetworkopen.2026.16556

  View details for PubMedID 42101844

• Association between common telomere length genetic variants and telomere length in an African population and impacts of HIV and TB. Journal of human genetics Wang, S., Chang, E., Byanyima, P., Huang, P., Sanyu, I., Musisi, E., Sessolo, A., Davis, J. L., Worodria, W., Huang, L., Lin, J. 2019; 64 (10): 1033-1040

  Abstract

  Prior studies in predominantly European (Caucasian) populations have discovered common genetic variants (single nucleotide polymorphisms, SNPs) associated with leukocyte telomere length (LTL), but whether these same variants affect LTL in non-Caucasian populations are largely unknown. We investigated whether six genetic variants previously associated with LTL (TERC (rs10936599), TERT (rs2736100), NAF1 (7675998), OBFC1 (rs9420907), ZNF208 (rs8105767), and RTEL1 (rs755017)) are correlated with telomere length (TL) in peripheral blood mononuclear cells (PBMCs) in a cohort of Africans living with and without HIV and undergoing evaluation for tuberculosis (TB). We found OBFC1 and the genetic sum score of the effect alleles across all six loci to be associated with shorter TL (adjusted for age, gender, HIV status, and smoking pack-years (p < 0.02 for both OBFC1 and the genetic sum score). In an analysis stratified by HIV status, the genetic sum score is associated with LTL in both groups with and without HIV. On the contrary, a stratified analysis according to TB status revealed that in the TB-positive subgroup, the genetic sum score is not associated with LTL, whereas the relationship remains in the TB-negative subgroup. The different impacts of HIV and TB on the association between the genetic sum score and LTL indicate different modes of modification and suggest that the results found in this cohort with HIV and TB participants may not be applied to the African general population. Future studies need to carefully consider these confounding factors.

  View details for DOI 10.1038/s10038-019-0646-9

  View details for PubMedID 31388112

  View details for PubMedCentralID PMC7039711

• Review of Ocular Manifestations of Joubert Syndrome. Genes Wang, S. F., Kowal, T. J., Ning, K., Koo, E. B., Wu, A. Y., Mahajan, V. B., Sun, Y. 2018; 9 (12)

  Abstract

  Joubert syndrome is a group of rare disorders that stem from defects in a sensory organelle, the primary cilia. Affected patients often present with disorders involving multiple organ systems, including the brain, eyes, and kidneys. Common symptoms include breathing abnormalities, mental developmental delays, loss of voluntary muscle coordination, and abnormal eye movements, with a diagnostic "molar tooth" sign observed by magnetic resonance imaging (MRI) of the midbrain. We reviewed the ocular phenotypes that can be found in patients with Joubert syndrome. Ocular motor apraxia is the most frequent (80% of patients), followed by strabismus (74%) and nystagmus (72%). A minority of patients also present with ptosis (43%), chorioretinal coloboma (30%), and optic nerve atrophy (22%). Although mutations in 34 genes have been found to be associated with Joubert syndrome, retinal degeneration has been reported in only 38% of patients. Mutations in AHI1 and CEP290, genes critical to primary cilia function, have been linked to retinal degeneration. In conclusion, Joubert syndrome is a rare pleiotropic group of disorders with variable ocular presentations.

  View details for PubMedID 30518138

• In vitro proinflammatory gene expression predicts in vivo telomere shortening: A preliminary study. Psychoneuroendocrinology Lin, J., Sun, J., Wang, S., Milush, J. M., Baker, C. A., Coccia, M., Effros, R. B., Puterman, E., Blackburn, E., Prather, A. A., Epel, E. 2018; 96: 179-187

  Abstract

  The chronic psychological stress of caregiving leads to higher risks for many diseases. One of the mechanisms through which caregiving is associated with disease risk is chronic inflammation. Chronic inflammation may accelerate cellular aging via telomere dysfunction and cell senescence, although this has not been examined in human cells from healthy people. We examined peripheral blood mononuclear cells (PBMCs) from 20 healthy mothers of children with autism (caregivers) and 19 mothers of neurotypical children (controls) in an in vitro culture system where PBMCs were stimulated with phytohaemagglutinin (PHA). We measured RNA expression levels of a panel of immune function genes before and after PHA stimulation, as well as telomere length from PBMCs collected from the participants at baseline and 15 months later. Caregivers and controls had similar gene expression profiles in unstimulated PBMCs, but after PHA stimulation, caregivers had increased RNA levels of the master inflammatory regulator NF-κB and its proinflammatory cytokine targets IL-1β, IL-6 and its receptor IL-6R as well as inflammatory chemokines IL-8, CXCL1 and CXCL2. Gene expression analysis suggested caregivers have increased Treg and Th17 T cell differentiation. Additionally, key signaling molecules involved in the upregulation of COX-2, a critical enzyme in the synthesis of the inflammatory mediator prostaglandin, were elevated. When both groups were examined together, higher expression levels of proinflammatory genes were associated with shorter telomere length in PBMCs from blood drawn 15 months later, independent of baseline telomere length. Taken together, these results suggest that chronic stress is associated with an exaggerated inflammatory response in PBMCs, which in turn is associated with shorter telomere length measured from PBMCs collected 15 months later. To our knowledge, this is the first human study that shows increased proinflammatory expression predicts future telomere shortening.

  View details for DOI 10.1016/j.psyneuen.2018.06.020

  View details for PubMedID 29980010