Karen Wernli, PhD, is a cancer epidemiologist and health services researcher whose work focuses on incorporating patient-centered outcomes to improve cancer care from prevention to survivorship. Her works spans many types of cancer, including breast, colorectal, lung, and ovarian. Her research strives to answer critical questions at the confluence of patients’ needs and clinical care.
Dr. Wernli recently completed a Patient-Centered Outcomes Research Institute (PCORI) project that compared breast magnetic resonance imaging (MRI) to mammography for women already treated for breast cancer. Called Surveillance Imaging Modalities for Breast Cancer Assessment (SIMBA), the 3-year 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 a National Cancer Institute (NCI)-funded study to examine trends and outcomes related to the mandatory notification of breast density that has been enacted in many states. With colleagues at Georgetown University, she is working on another NCI-funded study looking at the best ways to inform women about breast cancer risk and options for managing it. She is collaborating with Dr. Natasha Stout at Harvard University, using national claims data, to study the impact of density legislation on changes in breast imaging tests. Research from these studies has been presented at the American Society for Preventive Oncology, International Cancer Research Network, and International Breast Density & Cancer Risk Assessment Workshop.
In the Clare Project, Dr. Wernli launched a new direction in adolescent and young adult (AYA) cancer patients. Working with colleagues at KPWHRI, she evaluated patient, caregiver, and provider perspectives regarding medical decision making in patients with advanced cancer. Using novel methods, all perspectives were garnered through social media recruitment. With NCI-funding, she has evaluated national claims data of end-of-life care in AYA populations. Future research will build on these initial efforts.
Finally, Dr. Wernli is establishing a patient advisory board among Kaiser Permanente members participating in lung cancer screening. She is also evaluating cancer screening processes through quantitative and qualitative methods.
Dr. Wernli joined KPWHRI in 2009, following post-doctoral training at the Fred Hutchinson Cancer Research Center. She is a member of American Society for Preventive Oncology, Society for Epidemiologic Research, American Society for Clinical Oncology, and American Association for Cancer Research. She is a standing reviewer for American Cancer Society, and routinely reviews grants for the National Institutes of Health. She is also an affiliate associate professor of health services at the University of Washington.
Breast, lung, colorectal, ovarian, skin, and endometrial cancer; screening and surveillance; survivorship; patient-centered care; biostatistics; mammography; mammographic breast density; low-dose CT (LDCT); systematic reviews
Comparative effectiveness research; health outcomes research
Cancer screening and surveillance
Patient engagement, stakeholder engagement, qualitative research methods
Textile workers in China
Buist DSM, Abraham L, Lee CI, Lee JM, Lehman C, O'Meara ES, Stout NK, Henderson LM, Hill D, Wernli KJ, Haas JS, Tosteson ANA, Kerlikowske K, Onega T. Breast biopsy intensity and findings following breast cancer screening in women with and without a personal history of breast cancer. JAMA Intern Med. 2018 Feb 12. pii: 2672204. doi: 10.1001/jamainternmed.2017.8549. [Epub ahead of print]. PubMed
Miles R, Wan F, Onega TL, Lenderink-Carpenter A, O'Meara ES, Zhu W, Henderson LM, Haas JS, Hill DA, Tosteson ANA, Wernli KJ, Alford-Teaster J, Lee JM, Lehman CD, Lee CI. Underutilization of supplemental magnetic resonance imaging screening among patients at high breast cancer risk. J Womens Health (Larchmt). 2018 Jan 17. doi: 10.1089/jwh.2017.6623. [Epub ahead of print]. PubMed
Henderson LM, Hubbard RA, Zhu W, Weiss J, Wernli KJ, Goodrich ME, Kerlikowske K, DeMartini W, Ozanne EM, Onega T. Preoperative breast magnetic resonance imaging use by breast density and family history of breast cancer. J Womens Health (Larchmt). 2018 Jan 15. doi: 10.1089/jwh.2017.6428. [Epub ahead of print]. PubMed
Roth JA, Carter-Harris L, Brandzel S, Buist DSM, Wernli KJ. A qualitative study exploring patient motivations for screening for lung cancer. PLoS One. 2018 Jul 5;13(7):e0196758. doi: 10.1371/journal.pone.0196758. eCollection 2018. PubMed
Hill DA, Haas JS, Wellman R, Hubbard RA, Lee CI, Alford-Teaster J, Wernli KJ, Henderson LM, Stout NK, Tosteson ANA, Kerlikowske K, Onega T. Utilization of breast cancer screening with magnetic resonance imaging in community practice. J Gen Intern Med. 2018 Mar;33(3):275-283. doi: 10.1007/s11606-017-4224-6. Epub 2017 Dec 6. PubMed
Onega T, Weiss JE, Goodrich ME, Zhu W, DeMartini WB, Kerlikowske K, Ozanne E, Tosteson ANA, Henderson LM, Buist DSM, Wernli KJ, Herschorn SD, Hotaling E, O'Donoghue C, Hubbard R. Relationship between preoperative breast MRI and surgical treatment of non-metastatic breast cancer. J Surg Oncol. 2017 Dec;116(8):1008-1015. doi: 10.1002/jso.24796. Epub 2017 Nov 11. PubMed
Sakoda LC, Henderson LM, Caverly TJ, Wernli KJ, Katki HA. Applying risk prediction models to optimize lung cancer screening: current knowledge, challenges, and future directions. Curr Epidemiol Rep (2017). https://doi.org/10.1007/s40471-017-0126-8.
Lee JM, Ichikawa L, Valencia E, Miglioretti DL, Wernli K, Buist DSM, Kerlikowske K, Henderson LM, Sprague BL, Onega T, Rauscher GH, Lehman CD. Performance benchmarks for screening breast MR imaging in community practice. Radiology. 2017 Oct;285(1):44-52. doi: 10.1148/radiol.2017162033. PubMed
Sethi R, Buchlak QD, Yanamadala V, Anderson ML, Baldwin EA, Mecklenburg RS, Leveque JC, Edwards AM, Shea M, Ross L, Wernli KJ. A systematic multidisciplinary initiative for reducing the risk of complications in adult scoliosis surgery. J Neurosurg Spine. 2017 Mar 31:1-7. doi: 10.3171/2016.11.SPINE16537. [Epub ahead of print]. PubMed
Balasubramanian BA, Garcia MP, Corley DA, Doubeni CA, Haas JS, Kamineni A, Quinn VP, Wernli K, Zheng Y, Skinner CS. Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems. Medicine (Baltimore). 2017;96(11):e6326. doi: 10.1097/MD.0000000000006326. PubMed
An epidemiologist identifies who is appropriately undergoing this imaging for breast cancer and who is not.
Now’s the time, Dr. Wernli says, to weigh in on lowering eligible age and pack-years smoked.
There’s much confusion about the new disease, but numbers don’t lie. The challenge is finding the right ones.
MedPage Today, Jul 24, 2019
Kaiser Permanente Washington has been part of the national Breast Cancer Surveillance Consortium since 1994. Learn more about the Kaiser Permanente Washington Breast Cancer Surveillance Registry.
Reuters (via Medscape), Jun 7, 2019