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
Knerr S, Wernli KJ, Leppig K, Ehrlich K, Graham AL, Farrell D, Evans C, Luta G, Schwartz MD, O'Neill SC. A web-based personalized risk communication and decision-making tool for women with dense breasts: design and methods of a randomized controlled trial within an integrated health care system. Contemp Clin Trials. 2017 Feb 28;56:25-33. doi: 10.1016/j.cct.2017.02.009. [Epub ahead of print]. PubMed
Wernli KJ, Arao RF, Hubbard RA, Sprague BL, Alford-Teaster J, Haas JS, Henderson L, Hill D, Lee CI, Tosteson AN, Onega T. Change in breast cancer screening intervals since the 2009 USPSTF Guideline. J Womens Health (Larchmt). 2017 Feb 8. doi: 10.1089/jwh.2016.6076. [Epub ahead of print]. PubMed
Brandzel S, Rosenberg DE, Johnson D, Bush M, Kerlikowske K, Onega T, Henderson L, Nekhlyudov L, DeMartini W, Wernli KJ. Women's experiences and preferences regarding breast imaging after completing breast cancer treatment. Patient Prefer Adherence. 2017 Feb 1;11:199-204. doi: 10.2147/PPA.S122244. eCollection 2017. PubMed
Carter-Harris L, Brandzel S, Wernli KJ, Roth JA, Buist DS. A qualitative study exploring why individuals opt out of lung cancer screening. Fam Pract. 2017 Apr 1;34(2):239-244. doi: 10.1093/fampra/cmw146. PubMed
Wernli KJ, Brenner A, Rutter CM, Inadomi JM. Response to sedation and colonoscopy. Gastroenterology. 2016;151(3):564
Lavallee DC, Gore JL, Lawrence SO, Lindsay J, Marsh S, Scott MR, Wernli K. Initiative to support patient involvement in research (INSPIRE): community workshop report [internet].
Shortreed SM, Johnson EJ, Rutter CM, Kamineni A, Wernli KJ, Chubak J. Cohort restriction based on prior enrollment: Examining potential biases in estimating cancer and mortality risk. Obs Stud. 2016 Aug;2:51-64. Epub 2016 Sep 26. PubMed
Lavallee DC, Gore JL, Lawrence SO, Lindsay J, Marsh S, Scott MR, Wernli K. Initiative to Support Patient Involvement in Research (INSPIRE): findings from phase I interviews [internet].
Wernli KJ, Brenner AT, Rutter CM, Inadomi J. Reply. Gastroenterology. 2016 Aug 2. pii: S0016-5085(16)34888-0. doi: 10.1053/j.gastro.2016.07.041. [Epub ahead of print]. PubMed
Hubbard RA, O'Meara ES, Henderson LM, Hill D, Braithwaite D, Haas JS, Lee CI, Sprague BL, Alford-Teaster J, Tosteson AN, Wernli KJ, Onega T. Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S. Prev Med. 2016 Aug;89:169-77. doi: 10.1016/j.ypmed.2016.05.034. Epub 2016 May 31. 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