Leslie Lenert

• MD, MS
• Medical University of South Carolina

Objectives This study aims to summarize the usage of large language models (LLMs) in the process of creating a scientific review by looking at the methodological papers that describe the use of LLMs in review automation and the review papers that mention they were made with the support of LLMs. Materials and Methods The search was conducted in Jun...

Marital status and its dynamics significantly influence health outcomes. This study aims to demonstrate clinical utility of marital status and improve its extraction from electronic health records (EHR) by developing ensembles capable of using structured and unstructured EHR data. Four ensembles based on different voting rules (unanimous vote, majo...

This meta-analysis aims to examine gender differences in depression symptoms across various age groups and specific population samples, using an automated review approach powered by large language models (LLMs). Articles were retrieved using a PubMed-based pattern-matching tool, followed by OpenAI LLM inferences to identify studies reporting gender...

A growing body of literature has examined the impact of neighborhood characteristics on Alzheimer’s disease (AD) dementia, yet the spatial variability and relative importance of the most influential factors remain underexplored. We compiled various widely recognized factors to examine spatial heterogeneity and associations with AD dementia prevalen...

Importance It remains unclear whether children and adolescents with SARS-CoV-2 infection are at heightened risk for long-term kidney complications. Objective To investigate whether SARS-CoV-2 infection is associated with an increased risk of postacute kidney outcomes among pediatric patients, including those with preexisting kidney disease or acut...

Objectives This article describes the challenges faced by the National Library of Medicine with the rise of artificial intelligence (AI) and access to human knowledge through large language models (LLMs). Background and Significance The rise of AI as a tool for the acceleration and falsification of science is impacting every aspect of the transfor...

The consent process for research studies can be burdensome for potential participants due to complex information and lengthy consent forms. This pragmatic study aimed to improve the consent experience and evaluate its impact on participant decision making, study knowledge, and satisfaction with the In Our DNA SC program, a population-based genomic...

Background Increase in early onset colorectal cancer makes adherence to screening a significant public health concern, with various social determinants playing a crucial role in its incidence, diagnosis, treatment, and outcomes. Stressful life events, such as divorce, marriage, or sudden loss of job, have a unique position among the social determin...

Child abuse and neglect is a public health concern impacting youth throughout the world. Identifying child abuse and neglect in clinical practice can be challenging due to the lack of a “gold standard.” Existing racial and other biases may impact marginalized communities in reporting, identification, and intervention practices for child abuse. Exte...

Background/objective: Depression is a complex mental health disorder influenced by various social determinants of health (SDOH) at individual and community levels. Area-level factors and intersectionality framework, which considers overlapping personal identities, are used in this paper to get a nuanced picture of depression disparities. Methods Th...

Objectives: This scoping review aims to clarify the definition and trajectory of citizen-led scientific research (so-called citizen science) within the healthcare domain, examine the degree of integration of machine learning (ML) and the participation levels of citizen scientists in health-related projects. Materials and Methods: In January and Sep...

Previous studies indicate that increased healthcare access through Medicaid expansion and alleviation of socioeconomic stressors via higher minimum wages improved health outcomes. This study investigates the spatial relationships between the Medicaid expansion, minimum wage policy, and Alzheimer’s Disease (AD) dementia prevalence across the US. We...

Background Electronic health records (EHRs) commonly contain patient addresses that provide valuable data for geocoding and spatial analysis, enabling more comprehensive descriptions of individual patients for clinical purposes. Despite the widespread use of EHRs in clinical decision support and interventions, no systematic review has examined the...

BACKGROUND The usage of natural language processing (NLP) in mental health research is increasing with a wide range of applications and datasets being investigated. OBJECTIVE This review aims to summarize the usage NLP in mental health research, with a special focus on the types of text datasets and the usage of social determinants of health (SDOH...

Background The use of natural language processing (NLP) in mental health research is increasing, with a wide range of applications and datasets being investigated. Objective This review aims to summarize the use of NLP in mental health research, with a special focus on the types of text datasets and the use of social determinants of health (SDOH)...

Previous studies indicate that improved healthcare access through Medicaid expansion and alleviation of socioeconomic stressors via higher minimum wages improved health outcomes. This study investigates the spatial relationships between the Medicaid expansion, minimum wage policy, and AD dementia prevalence across the US. We employed the Getis-Ord...

Objective: This study aims to summarize the usage of Large Language Models (LLMs) in the process of creating a scientific review. We look at the range of stages in a review that can be automated and assess the current state-of-the-art research projects in the field. Materials and Methods: The search was conducted in June 2024 in PubMed, Scopus, Dim...

BACKGROUND Increase in early onset colorectal cancer makes adherence to screening a significant public health concern with various social determinants playing a crucial role in its incidence, diagnosis, treatment, and outcomes. Stressful life events, such as divorce, marriage, or sudden loss of job, have a unique position among the social determina...

Importance Intimate partner violence (IPV) is a significant public health issue, with a 25% lifetime prevalence. Screening for IPV in primary care is a recommended practice whose effectiveness is debated. Objective To assess the effect of an electronic health record (EHR)–based multifactorial intervention screening on the detection of IPV risk in...

Objectives: In hospitalized patients, cigarette smoking is linked to increased readmission rates, emergency department visits, and overall mortality. Smoking cessation reduces these risks, but many patients who smoke are unsuccessful in quitting. Nicotine replacement therapy (NRT) is an effective tool that assists patients who smoke with quitting....

Background: In recent years, a growing body of literature has examined the impact of neighborhood characteristics on Alzheimer's disease (AD) dementia. However, spatial variability of the most influential variables and their relative importance to AD dementia prevalence remain underexplored. Methods: We compiled various widely recognized factors to...

We investigated the risks of post-acute and chronic adverse kidney outcomes of SARS-CoV-2 infection in the pediatric population via a retrospective cohort study using data from the RECOVER program. We included 1,864,637 children and adolescents under 21 from 19 children’s hospitals and health institutions in the US with at least six months of follo...

Background: Lung cancer screening with annual low-dose computed tomography (LDCT) in high-risk patients with exposure to smoking reduces lung cancer-related mortality, yet the screening rate of eligible adults is low. As hospitalization is a critical moment to engage patients in their overall health, it may be an opportunity to improve rates of lun...

Researchers across the translational research continuum have emphasized the importance of integrating genomics into their research program. To date capacity and resources for genomics research have been limited; however, a recent population-wide genomic screening initiative launched at the Medical University of South Carolina in partnership with He...

Objectives Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer 2 major questions: how stressful life events are documented in EHR and how they are utilized in resea...

BACKGROUND Electronic health records (EHR) commonly contain patient addresses that provide valuable data for geocoding and spatial analysis, enabling more comprehensive descriptions of individual patients for clinical purposes. Despite the widespread use of EHR in clinical decision support and interventions, no systematic review has examined the ex...

Introduction This study aimed to identify barriers and facilitators to the implementation of family cancer history (FCH) collection tools in clinical practices and community settings by assessing clinicians’ perceptions of implementing a chatbot interface to collect FCH information and provide personalized results to patients and providers. Object...

Background: To help control the COVID-19 pandemic, Google and Apple collaborated to launch the Google/Apple Exposure Notification System (GAEN), an app that notifies users following exposure to COVID-19. Clemson University piloted the launch of the app on campus to support the university health system’s case identification and exposure control. Thi...

Background Child abuse and neglect (CAN) is prevalent, associated with long-term adversities, and often undetected. Primary care settings offer a unique opportunity to identify CAN and facilitate referrals, when warranted. Electronic health records (EHR) contain extensive information to support healthcare decisions, yet time constraints preclude mo...

Importance The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain. Objective To assess the effectiveness of fluvoxamine, 100 mg twice daily, compared with placebo, for treating mild to moderate COVID-19. Design, Setting, and Participants The ACTIV-6 platform randomized...

Objective. Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer two major questions: how stressful life events are documented in EHR and how they are utilized in res...

Objective. Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer two major questions: how stressful life events are documented in EHR and how they are utilized in res...

Objectives: Health information systems (HIS) commonly contain patient addresses that provide valuable data for geocoding and spatial analysis, enabling more comprehensive descriptions of individual patients in biomedical studies. Despite the widespread adoption of HIS, no systematic review has examined the extent to which spatial analysis is used i...

Background: Electronic health records (EHR) commonly contain patient addresses that provide valuable data for geocoding and spatial analysis, enabling more comprehensive descriptions of individual patients for clinical purposes. Despite the widespread use of EHR in clinical decision support and interventions, no systematic review has examined the e...

Cancer is the second leading cause of death in the United States, and breast cancer is the fourth leading cause of cancer-related death, with 42,275 women dying of breast cancer in the United States in 2020. Screening is a key strategy for reducing mortality from breast cancer and is recommended by various national guidelines. This study applies ma...

Background Characterizing Post-Acute Sequelae of COVID (SARS-CoV-2 Infection), or PASC has been challenging due to the multitude of sub-phenotypes, temporal attributes, and definitions. Scalable characterization of PASC sub-phenotypes can enhance screening capacities, disease management, and treatment planning. Methods We conducted a retrospective...

COVID-19 infection has resulted in significant morbidity and mortality globally, especially among older adults. Repurposed drugs have demonstrated activity in respiratory illnesses, including nitrogen-containing bisphosphonates. In this retrospective longitudinal study at 4 academic medical centers, we show no benefit of nitrogen-containing bisphos...

Background Accurate identification of opioid overdose (OOD) cases in electronic healthcare record (EHR) data is an important element in surveillance, empirical research, and clinical intervention. We sought to improve existing OOD electronic phenotypes by incorporating new data types beyond diagnostic codes and by applying several statistical and m...

Objective: The annual American College of Medical Informatics (ACMI) symposium focused discussion on the national public health information systems (PHIS) infrastructure to support public health goals. The objective of this article is to present the strengths, weaknesses, threats, and opportunities (SWOT) identified by public health and informatic...

In 2021, the Medical University of South Carolina (MUSC) XXXX launched In Our DNA SC. This large-scale initiative will screen 100,000 individuals in South Carolina for three preventable hereditary conditions that impact approximately two million people in the USA but often go undetected. In anticipation of inevitable changes to the delivery of this...

The COVID-19 pandemic exposed multiple weaknesses in the nation's public health system. Therefore, the American College of Medical Informatics selected "Rebuilding the Nation's Public Health Informatics Infrastructure" as the theme for its annual symposium. Experts in biomedical informatics and public health discussed strategies to strengthen the U...

Prior authorization (PA) may be a necessary evil within the healthcare system, contributing to physician burnout and delaying necessary care, but also allowing payers to prevent wasting resources on redundant, expensive, and/or ineffective care. PA has become an “informatics issue” with the rise of automated methods for PA review, championed in the...

Importance It is unknown whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate COVID-19. Objective To evaluate the effectiveness of ivermectin at a maximum targeted dose of 600 μg/kg daily for 6 days, compared with placebo, for the treatment of e...

Intimate partner violence is, unfortunately, a common problem (25% of women) for which screening in primary care is a recommended service. In this paper, we describe modifications to a commercial EHR system (Epic) designed to support confidential screening for and management of IPV in primary care settings. Modifications include the use of an exam...

Objective Opioid-related overdose (OD) deaths continue to increase. Take-home naloxone (THN), after treatment for an OD in an emergency department (ED), is a recommended but under-utilized practice. To promote THN prescription, we developed a noninterruptive decision support intervention that combined a detailed OD documentation template with a rem...

Background While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking. Methods A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis...

Importance The COVID-19 pandemic has been associated with an increase in mental health diagnoses among adolescents, though the extent of the increase, particularly for severe cases requiring hospitalization, has not been well characterized. Large-scale federated informatics approaches provide the ability to efficiently and securely query health car...

COVID-19 vaccination uptake has been suboptimal, even in high-risk populations. New approaches are needed to bring vaccination data to the groups leading outreach efforts. This article describes work to make state-level vaccination data more accessible by extending the Bulk Fast Healthcare Interoperability Resource (FHIR) standard to better support...

COVID-19 vaccination uptake has been suboptimal, even in high-risk populations. This paper describes work to extend the Bulk Fast Healthcare Interoperability Resource (FHIR) standard for use in querying state Immunization Information Systems (IIS). We also describe a population vaccination outreach tool that uses both Bulk FHIR and automated single...

Importance The effectiveness of ivermectin to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic COVID-19 is unknown. Objective To evaluate the efficacy of ivermectin, 400 μg/kg, daily for 3 days compared with placebo for the treatment of early mild to moderate COVID-19. Design, Setti...

Background: Child abuse and neglect (CAN) is prevalent, associated with long-term adversities, and often undetected. Primary care settings offer a unique opportunity to identify CAN and facilitate referrals, when warranted. Electronic health records (EHR) contain extensive information to support healthcare decisions, yet time constraints preclude m...

Background and Objectives: Genomic information is increasingly relevant for disease prevention and risk management at the individual and population levels. Screening healthy adults for Tier 1 conditions of hereditary breast and ovarian cancer, Lynch syndrome, and familial hypercholesterolemia using a population-based approach can help identify the...

Opioid Overdose Network is an effort to generalize and adapt an existing research data network, the Accrual to Clinical Trials (ACT) Network, to support design of trials for survivors of opioid overdoses presenting to emergency departments (ED). Four institutions (Medical University of South Carolina [MUSC], Dartmouth Medical School [DMS], Universi...

Background: Using the International Classification of Diseases (ICD) codes alone to record opioid use disorder (OUD) may not completely document OUD in the electronic health record (EHR). We developed and evaluated natural language processing (NLP) approaches to identify OUD from the clinal note. We explored the concordance between ICD-coded and NL...

Given the growing number of prediction algorithms developed to predict COVID-19 mortality, we evaluated the transportability of a mortality prediction algorithm using a multi-national network of healthcare systems. We predicted COVID-19 mortality using baseline commonly measured laboratory values and standard demographic and clinical covariates acr...

Background: In 2021, the Medical University of South Carolina (MUSC) partnered with Helix, a population genetic testing company, to offer population-wide genomic screening for Centers for Disease Control and Preventions' Tier 1 conditions of hereditary breast and ovarian cancer, Lynch syndrome, and familial hypercholesterolemia to 100,000 individu...

Research Patient Data Repositories (RPDRs) have become essential infrastructure for traditional Clinical and Translational Science Award (CTSA) programs and increasingly for a wide range of research consortia and learning health system networks.1–5 Almost every institution with a CTSA or Clinical Translational Research (CTR) program (found in state...

In response to the emerging COVID-19 public health emergency in March 2020, the Medical University of South Carolina rapidly implemented an analytics-enhanced remote patient monitoring (RPM) program with state-wide reach for SARS-CoV-2-positive patients. Patient-reported data and other analytics were used to prioritize the sickest patients for cont...

Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participat...

Background For some SARS-CoV-2 survivors, recovery from the acute phase of the infection has been grueling with lingering effects. Many of the symptoms characterized as the post-acute sequelae of COVID-19 (PASC) could have multiple causes or are similarly seen in non-COVID patients. Accurate identification of PASC phenotypes will be important to gu...

BACKGROUND The infectivity characteristics of SARS-Cov-2 require expeditious testing and isolation of cases for pandemic control. The large proportion of very severe or deadly cases, combined with a lack of specific treatment options for SARS-CoV-2, makes it imperative to identify and isolate infected individuals and quickly test their exposed clos...

Background: As SARS-CoV-2, the virus that causes COVID-19, spread rapidly across the United States in the spring of 2020, institutions of higher education faced numerous challenges associated with minimizing risk of exposure to COVID-19 among their students, faculty, staff, and surrounding communities. This paper describes the protocol, South Caro...

Objective Opioid Overdose Network is an effort to generalize and adapt an existing research data network, the Accrual to Clinical Trials (ACT) Network, to support design of trials for survivors of opioid overdoses presenting to emergency departments (ED). Four institutions (Medical University of South Carolina (MUSC), Dartmouth Medical School (DMS)...

Importance Additional sources of pediatric epidemiological and clinical data are needed to efficiently study COVID-19 in children and youth and inform infection prevention and clinical treatment of pediatric patients. Objective To describe international hospitalization trends and key epidemiological and clinical features of children and youth with...

Objective The rapidly evolving COVID-19 pandemic has created a need for timely data from the healthcare systems for research. To meet this need, several large new data consortia have developed that require frequent updating and sharing of electronic health record (EHR) data in different common data models (CDMs) to create multi-institutional databa...

SARS-CoV-2 has engulfed our world over the course of the last year. Hospitals have experienced case surges and have had to innovate and adapt to care for these patients. This article represents qualitative experiences of providers working in a surge ICU. The codes, subsequent themes, and challenges identified here bring forth perspectives of provid...

Public health faces unprecedented challenges in its efforts to control COVID-19 through a national vaccination campaign. Addressing these challenges will require fundamental changes to public health data systems. For example, one of the core data systems for immunization campaigns is the immunization information system (IIS); however, IISs were des...

Background Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via mHealth solutions.Methods Semi-structured qualitative interviews were conducted with nation...

Objective Integrated, real-time data are crucial to evaluate translational efforts to accelerate innovation into care. Too often, however, needed data are fragmented in disparate systems. The South Carolina Clinical & Translational Research Institute at the Medical University of South Carolina (MUSC) developed and implemented a universal study iden...

Objective: Objective: The COVID-19 pandemic has enhanced the need for timely real-world data (RWD) for research. To meet this need, several large clinical consortia have developed networks for access to RWD from electronic health records (EHR), each with its own common data model (CDM) and custom pipeline for extraction, transformation, and load op...

BACKGROUND Public health reporting is the cornerstone of public health practice that inform the prevention and control strategies. Over the years, public health reporting has advanced to automated electronic methods but have been fraught with complex nuances in clinical and public health workflows, data and messaging standards, and efficient proces...

Background Public health reporting is the cornerstone of public health practices that inform prevention and control strategies. There is a need to leverage advances made in the past to implement an architecture that facilitates the timely and complete public health reporting of relevant case-related information that has previously not easily been a...

The ability to analyze human specimens is the pillar of modern-day translational research. To enhance the research availability of relevant clinical specimens, we developed the Living BioBank (LBB) solution, which allows for just-in-time capture and delivery of phenotyped surplus laboratory medicine specimens. The LBB is a system-of-systems integra...

The ability to analyze human specimens is the pillar of modern-day translational research. To enhance the research availability of relevant clinical specimens, we developed the Living BioBank (LBB) solution, which allows for just-in-time capture and delivery of phenotyped surplus laboratory medicine specimens. The LBB is a system-of-systems integra...

Background: COVID-19 challenges and needs required health systems to rapidly redesign the delivery of care. Objective: To describe our approach in using health information technology to provide a continuum of services during the COVID-19 pandemic. Materials and methods: Our health system deployed four COVID-19 telehealth programs, and four bio...

Public health needs up-to-date information for surveillance and response. As healthcare application programming interfaces become widely available, a novel data gathering mechanism could provide public health with critical information in a timely fashion to respond to a fast-moving epidemic. In this article, we extrapolate from our experiences usin...

Objective: In an effort to improve the efficiency of computer algorithms applied to screening for COVID-19 testing, we used natural language processing (NLP) and artificial intelligence (AI)-based methods with unstructured patient data collected through telehealth visits. Methods: After segmenting and parsing documents, we conducted analysis of...

The novel coronavirus COVID-19 infection poses serious challenges to the healthcare system that are being addressed through the creation of new unique and advanced systems of care with disjointed care processes (telehealth screening, drive-through specimen collection, remote testing, telehealth management, etc.) However, our current regulations on...

Background. Accurate diagnosis of patients’ preferences is central to shared decision making. Missing from clinical practice is an approach that links pretreatment preferences and patient-reported outcomes. Objective. We propose a Bayesian collaborative filtering (CF) algorithm that combines pretreatment preferences and patient-reported outcomes to...

Adverse drug events (ADEs), defined as “any injuries resulting from medication use, including physical harm, mental harm, or loss of function,”¹ are reported to account for approximately 30% of all adverse events,² with results that can include repeated hospital admission and fatality. Information about causes of ADEs can be found in data that docu...

Dissemination and Continuous Improvement of a CTSA-based Software Platform, SPARCRequest©, Using an Open Source Governance Model – ADDENDUM - Wenjun He, Royce Sampson, Jihad Obeid, Kyle Hutson, Boyd M. Knosp, Bernard A. LaSalle, Brian Melancon, Kimberly McGhee, Leslie A. Lenert, Kathleen Brady

As an interdisciplinary technologically driven field, the science of informatics is rapidly evolving. In this issue of Journal of the American Medical Informatics Association, we bring together a series of articles and commentaries that describe various aspects of the science of predictive modeling. These articles describe work to ensure that model...

SPARCRequest© (Services, Pricing, & Application for Research Centers) is a web-based research management system that provides a a modular and adaptable “electronic storefront” for research-related services. Developed by the South Carolina Clinical & Translational Research Institute at the Medical University of South Carolina, it was released as ope...

Following publication of the original article [1], the authors reported an error in one of the authors’ names.

Background Social isolation is an important social determinant that impacts health outcomes and mortality among patients. The National Academy of Medicine recently recommended that social isolation be documented in electronic health records (EHR). However, social isolation usually is not recorded or obtained as coded data but rather collected from...