Karen J. Wernli, PhD

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“I consider patients the core of my research.”

Karen J. Wernli, PhD

Senior Scientific Investigator, Kaiser Permanente Washington Health Research Institute
Professor, Department of Health System Science, Kaiser Permanente Bernard J. Tyson School of Medicine
Affiliate Professor, Department of Epidemiology and Department of Health Systems and Population Health, University of Washington

Karen.J.Wernli@kp.org
206-287-2934
Twitter: @wernlikarenj

Biography

Karen Wernli, PhD, is a cancer epidemiologist and health services researcher whose work focuses on incorporating patient-centered outcomes to improve cancer care along the cancer care continuum, from prevention to survivorship. Her works spans several types of cancer, including lung, breast, and colorectal, and also explores the impact of cancer in special populations, such as adolescents and young adults. Her research strives to answer critical questions at the confluence of patients’ needs and clinical priorities. Overall, her research has resulted in approximately $30 million in research funding as principal investigator (PI) or site PI, more than 125 peer-reviewed publications (h-index 35), and more than 85 presentations at national conferences, symposia, and other public venues.

Dr. Wernli is a leader in multilevel intervention studies to improve lung cancer screening. She is currently conducting a pragmatic clinical trial funded by the National Cancer Institute (NCI) to test 2 multilevel interventions to improve adherence to annual lung cancer screening at Kaiser Permanente Washington (R01CA262015). Study interventions were developed using a mixed-methods approach — including patient and stakeholder engagement and human-centered design methods — to determine gaps for interventions, relevant features of interventions, and design concepts. Further, Dr. Wernli is also leading a pilot grant from the Alliance for Clinical Trials in Oncology to develop interventions to improve timely follow-up after a positive lung cancer screening scan. She is cancer care delivery research lead for the Kaiser Permanente Washington NCI Community Oncology Research Program (NCORP).

Dr. Wernli is a leader in the use of breast imaging in women with prior breast cancer, including in the use of breast magnetic resonance imaging (MRI). Dr. Wernli recently completed a Patient-Centered Outcomes Research Institute (PCORI) project that compared breast MRI to mammography for women already treated for breast cancer. Called Surveillance Imaging Modalities for Breast Cancer Assessment (SIMBA), the study used data from the Breast Cancer Surveillance Consortium (BCSC) and engaged patients and stakeholders to determine the best information for patient and physician decision-making. Dr. Wernli’s team translated that information into a new decision aid for breast cancer survivors. PCORI has recognized this work nationally and pointed to SIMBA as a model for effective patient engagement.

Dr. Wernli’s other breast cancer projects include collaborating with Natasha Stout, PhD, from Harvard University on an NCI-funded study to examine trends and outcomes related to the mandatory notification of breast density that has been enacted in many states. She also led research to determine temporal trends in the use of breast MRI over 10 years, based on indication for the scans. The analysis relied on national claims-based data across all 50 states.

Dr. Wernli is leading patient-centered research in adolescent and young adult (AYA) populations. She is a project co-lead with Kaiser Permanente Southern California researcher Erin Hahn, PhD, MPH, and Veterans Affairs researcher Neetu Chawla, PhD, MPH, in an NCI-funded project to evaluate health service utilization in early survivorship for AYA populations. The research is intended to identify multilevel gaps in health care utilization in AYA early-cancer survivors for forthcoming interventions. Previously, Dr. Wernli launched the Clare Project with KPWHRI researchers, including Marlaine Figueroa Gray, PhD, to understand patient, caregiver, and provider perspectives regarding medical decision-making for patients with advanced cancer. Using novel methods, all perspectives were garnered through social media recruitment. With NCI-funding, she has evaluated temporal trends and regional variation in end-of-life care in AYA cancer populations using national claims-based data.

Finally, Dr. Wernli is expanding her research expertise in clinical research studies beyond oncology clinical trials. She is principal investigator of a multisite study of flu and COVID-19 vaccine effectiveness funded by the Centers for Disease Control and Prevention from 2022 to 2027. Her study team is annually enrolling about 1,200 participants with flu-like symptoms into her research.

Dr. Wernli is a member of the American Society for Preventive Oncology, the Society for Epidemiologic Research, the American Society for Clinical Oncology, and the American Association for Cancer Research. She is an affiliate professor of epidemiology and health systems and population health at the University of Washington and a professor of health system science at the Kaiser Permanente Bernard J. Tyson School of Medicine.

Research interests and experience

  • Cancer

    Breast, lung, colorectal, ovarian, skin, and endometrial cancer; screening and surveillance; survivorship; patient-centered care; biostatistics; low-dose CT (LDCT); mammography; surveillance imaging; breast magnetic resonance imaging (MRI); systematic reviews; multilevel intervention studies; pragmatic clinical trials

  • Health Services & Economics

    Comparative effectiveness research, health outcomes research, patient-centered outcomes, health care quality, implementation science

    Preventive Medicine

    Cancer screening and surveillance

  • Patient-Centeredness

    Patient engagement, stakeholder engagement, qualitative research methods, mixed-methods, human-centered design

  • Vaccines & Infectious Diseases

  • Aging & Geriatrics

Recent publications

Carter-Bawa L, Slaven JE Jr, Monahan PO, Brandzel S, Gao H, Wernli KJ, Elston Lafata J, Rawl SM. Unpacking the relationship between shared decision-making and decisional quality, decision to screen, and screening completion in lung cancer screening. Patient Educ Couns. 2024 Jan 11:122:108143. doi: 10.1016/j.pec.2024.108143. PubMed

Sandford R, Yadav R, Noble EK, Sumner K, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Belongia EA, Carlson C, Coughlin M, Flannery B, Pearce B, Rogier E. Antibody response to symptomatic infection with SARS-CoV-2 Omicron variant viruses, December 2021-June 2022. medRxiv. 2023:2023.11.17.23298700. doi: 10.1101/2023.11.17.23298700. Preprint. PubMed

Kerlikowske K, Zhu W, Su YR, Sprague BL, Stout NK, Onega T, O'Meara ES, Henderson LM, Tosteson ANA, Wernli K, Miglioretti DL. Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst. 2023 Oct 27:djad201. doi: 10.1093/jnci/djad201. [Epub ahead of print]. PubMed

Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 antibody levels associated with COVID-19 protection in outpatients tested for SARS-CoV-2, US Flu VE Network, October 2021-June 2022. medRxiv. 2023:2023.09.21.23295919. doi: 10.1101/2023.09.21.23295919. Preprint. PubMed

Hahn EE, Staab J, Munoz-Plaza C, Gander J, Kushi L, McMullin C, Oshiro C, Wernli KJ, Ritzwoller D. Incidence and survival for breast, colorectal and lung cancer patients in an integrated system. Perm J. 2023 Sep 19;1-7. doi: 10.7812/TPP/23.021. Online ahead of print. PubMed

Ahmed F, Nowalk MP, Zimmerman RK, Bear T, Grijalva CG, Talbot HK, Florea A, Tartof SY, Gaglani M, Smith M, McLean HQ, King JP, Martin ET, Monto AS, Phillips CH, Wernli KJ, Flannery B, Chung JR, Uzicanin A. Work attendance during acute respiratory illness before and during the COVID-19 pandemic, United States, 2018-2022. medRxiv 2023.

Lee JM, Ichikawa LE, Wernli KJ, Bowles EAJ, Specht JM, Kerlikowske K, Miglioretti DL, Lowry KP, Tosteson ANA, Stout NK, Houssami N, Onega T, Buist DSM. Impact of surveillance mammography intervals less than one year on performance measures in women with a personal history of breast cancer. J Korean Radiol. 2023 Aug;24(8):729-738. doi: 10.3348/kjr.2022.1038. PubMed

Knerr S, Guo B, Wernli KJ, Mittendorf KF, Feigelson HS, Gilmore MJ, Jarvik GP, Kauffman TL, Keast E, Liles EG, Lynch FL, Muessig KR, Okuyama S, Veenstra DL, Zepp JM, Wilfond BS, Devine B, Goddard KAB. Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system. Breast Cancer Res Treat. 2023 Oct;201(3):461-470. doi: 10.1007/s10549-023-07007-w. Epub 2023 Jul 20. PubMed

Tartof SY, Xie F, Yadav R, Wernli KJ, Martin ET, Belongia EA, Gaglani M, Zimmerman RK, Talbot HK, Thornburg N, Flannery B; US Flu VE Network Investigators. Prior SARS-CoV-2 infection and COVID-19 vaccine effectiveness against outpatient illness during widespread circulation of SARS-CoV-2 Omicron variant, US Flu VE network. Influenza Other Respir Viruses. 2023 May;17(5):e13143. doi: 10.1111/irv.13143. PubMed

Nichols H, Wernli KJ, Chawla N, O’Meara ES, Figueroa Gray M, Green LE, Baggett CD, Casperson M, Chao C, Jones SM, Kirchhoff AC, Kuo T, Lee C , Malogolowkin M, Quesenberry CP, Ruddy KJ, Wun T, Zebrack B, Chubak J, Hahn EE, Keegan TH, Kushi LH. Challenges and opportunities of epidemiological studies to reduce the burden of cancers in young adults. Curr Epidemiol Rep. 2023 Sep;10(3):115-124. doi: 10.1007/s40471-022-00286-9. Epub 2022 Mar 29. PubMed

 

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