Karen J. Wernli, PhD

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“I consider patients the core of my research.”

Karen J. Wernli, PhD

Associate Investigator, Kaiser Permanente Washington Health Research Institute

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 more than $15.5 million in external research funding, over 115 peer-reviewed publications, and more than 70 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. The purpose of the pilot grant is to develop a larger project within the 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 Dr. Natasha Stout 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 currently a project co-lead with Kaiser Permanente Southern California researcher Dr. Erin Hahn and Veterans Affairs researcher Dr. Neetu Chawla in an NCI-funded program 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 Dr. Marlaine Figueroa Gray, 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. She is currently the Cancer Care Delivery Research lead at Kaiser Permanente Washington. She is also principal investigator for KPWA of a multisite study of flu and COVID vaccine effectiveness funded by the Centers for Disease Control and Prevention.

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 a standing reviewer for the American Cancer Society, and routinely reviews grants for the National Institutes of Health. She is also an affiliate associate professor of population and epidemiology at the University of Washington.

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

Lowry KP, Callaway KA, Lee JM, Zhang F, Ross-Degnan D, Wharam JF, Kerlikowske K, Wernli KJ, Kurian AW, Henderson LM, Stout NK. Trends in annual surveillance mammography participation among breast cancer survivors from 2004 to 2016. J Natl Compr Canc Netw. 2022;20(4):379-386.e9. doi: 10.6004/jnccn.2021.7081. PubMed

Smith RE, Sprague B, Henderson LM, Kerlikowske K, Miglioretti DL, Buist DSM, Wernli KJ, Onega T, Schifferdecker K, Jackson-Nefertiti G, Johnson D, Budesky J, Tosteson ANA. Breast Density Knowledge in a Screening Mammography Population Exposed to Density Notification. LID - S1546-1440(22)00248-4 [pii] LID - 10.1016/j.jacr.2022.02.025 [doi] J Am Coll Radiol. 2022 Mar 24:S1546-1440(22)00248-4. doi: 10.1016/j.jacr.2022.02.025 [Epub ahead of print] PubMed

Chung JR, Kim SS, Kondor RJ, Smith C, Budd AP, Tartof SY, Florea A, Talbot HK, Grijalva CG, Wernli KJ, Phillips CH, Monto AS, Martin ET, Belongia EA, McLean HQ, Gaglani M, Reis M, Moehling Geffel K, Nowalk MP, DaSilva J, Keong LM, Stark TJ, Barnes JR, Wentworth DE, Brammer L, Burns E, Fry AM, Patel MM, Flannery BF. Interim estimates of 2021-22 seasonal influenza vaccine effectiveness - United States, February 2022. MMWR Morb Mortal Wkly Rep. 2022 Mar 11;71(10):365-370. doi: 10.15585/mmwr.mm7110a1. PubMed

Haas CB, Hsu L, Lampe JW, Wernli KJ, Lindström S. Cross-ancestry genome-wide association studies of sex hormone concentrations in pre- and postmenopausal women. Endocrinology. 2022 Feb 22:bqac020. doi: 10.1210/endocr/bqac020. Online ahead of print. PubMed

Holman A, Kross E, Crothers K, Cole A, Wernli K, Triplette M. Patient perspectives on longitudinal adherence to lung cancer screening. Chest. 2022 Feb 8:S0012-3692(22)00223-9. doi: 10.1016/j.chest.2022.01.054. [Epub ahead of print]. PubMed

Conley CC, Wernli KJ, Knerr S, Li T, Leppig K, Ehrlich K, Farrell D, Gao H, Bowles EJA, Graham AL, Luta G, Jayasekera J, Mandelblatt JS, Schwartz MD, O'Neill SC. Using protection motivation theory to predict intentions for breast cancer risk management: intervention mechanisms from a randomized controlled trial. J Cancer Educ. 2021 Nov 23. doi: 10.1007/s13187-021-02114-y. [Epub ahead of print]. PubMed

Schousboe JT, Sprague BL, Abraham L, O'Meara ES, Onega T, Advani S, Henderson LM, Wernli KJ, Zhang D, Miglioretti DL, Braithwaite D, Kerlikowske K. Cost-effectiveness of screening mammography beyond age 75 years: a cost-effectiveness analysis. Ann Intern Med. 2022 Jan;175(1):11-19. doi: 10.7326/M20-8076. Epub 2021 Nov 23. PubMed

Onega T, Zhu W, Kerlikowske K, Miglioretti DL, Lee CI, Henderson LM, Tosteson ANA, Wernli KJ, diFlorio R, Weaver DL, Buist DSM. Preoperative MRI in breast cancer: effect of breast density on biopsy rate and yield. Breast Cancer Res Treat. 2022 Jan;191(1):177-190. doi: 10.1007/s10549-021-06418-x. Epub 2021 Oct 22. PubMed

Lowry KP, Bissell M, Miglioretti DL, Kerlikowske K, Alsheik N, Macarol T, Bowles EJA, Buist DSM, Tosteson ANA, Henderson L, Herschorn SD, Wernli KJ, Weaver DL, Stout NK, Sprague BL. Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic. Radiology. 2021 Oct 19:211808. doi: 10.1148/radiol.2021211808. Online ahead of print. PubMed

Thompson MJ, Suchsland MZ, Hardy V, Lavallee D, Jarvik J, Walter F, Trikalinos T, Findlay S, Chou R, Green B, Wernli KJ, Lord S, Devine B, Bossuyt P. Patient-centred outcomes of imaging tests: recommendations for patients, clinicians and researchers. BMJ Qual Saf. 2021 Oct 6;bmjqs-2021-013311. doi: 10.1136/bmjqs-2021-013311. Online ahead of print. PubMed

 

Research

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Roundup of 3 recent studies on breast cancer screening

New research spotlights overdiagnosis, MRI before surgery, and a new way of predicting breast cancer risk

VOICE STUDY

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Understanding young adults’ experiences with cancer

The VOICE study aims to improve the health and health care of people who had cancer as adolescents and young adults.

Co-designing with patients

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Patient collaboration sparks care innovations

By partnering with patients, KPWHRI researchers developed 2 new interventions to boost lung cancer screening.

Cancer screening

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Catching breast cancers when mammograms are limited

New study calculates risk-based approach to detect the most cancers with the fewest exams.

healthy findings blog

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Which women are receiving MRI to screen for breast cancer?

An epidemiologist identifies who is appropriately undergoing this imaging for breast cancer and who is not.

healthy findings blog

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Lung cancer screening guidelines are changing

Now’s the time, Dr. Wernli says, to weigh in on lowering eligible age and pack-years smoked.