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
Hubbard R, Johnson E, Chubak J, Wernli KJ, Kamineni A, Bogart A, Rutter C. Estimating screening test effectiveness when screening indication is unknown using generalized linear finite mixture models. Health Services Outcomes Res Methodol.2017 17(2):101-112.
Wernli KJ, Henrikson NB, Morrison CC, Nguyen M, Pocobelli G, Blasi PR. Screening for skin cancer in adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA.2016;316(4):436-447. doi:10.1001/jama.2016.5415. PubMed
Hubbard RA, Johnson E, Chubak J, Wernli K, Kamineni A, Bogart A, Rutter CM. Accounting for misclassification in electronic health records-derived exposures using generalized linear finite mixture models. Health Serv Outcomes Res Methodol. 2017 Jun;17(2):101-112. doi: 10.1007/s10742-016-0149-5. Epub 2016 Jun 3. PubMed
Onega T, Weiss JE, Buist DS, Tosteson AN, Henderson LM, Kerlikowske K, Goodrich ME, O'Donoghue C, Wernli KJ, DeMartini WB, Virnig BA, Bennette CS, Hubbard RA. Breast MRI in the diagnostic and preoperative workup among Medicare beneficiaries with breast cancer. Med Care. 2016 Apr 22. [Epub ahead of print]. PubMed
Johnson D, Bush M, Brandzel S, Wernli KJ. The patient voice in research; evolution of a role. Res Involvement and Engagement.2016;2:6.
Haas JS, Hill DA, Wellman RD, Hubbard RA, Lee CI, Wernli KJ, Stout NK, Tosteson AN, Henderson LM, Alford-Teaster JA, Onega TL. Disparities in the use of screening magnetic resonance imaging of the breast in community practice by race, ethnicity, and socioeconomic status. Cancer. 2016 Feb 15;122(4):611-7. doi: 10.1002/cncr.29805. Epub 2015 Dec 28. PubMed
Wernli KJ, Arao RF, Hubbard RA, Sprague B, Alford-Teaster J, Haas J, Henderson L, Hill D, Lee C, Tosteson A, Onega T. How have breast cancer screening intervals changed since the 2009 USPSTF guideline update? Cancer Epidemiol Biomark Prev 2016;25:558.
Lee AY, Ichikawa L, Lee JM, Lee CI, DeMartini WB, Joe BN, Wernli KJ, Sprague BL, Herschorn SD, Lehman CD. Concordance of BI-RADS assessments and management recommendations for breast MRI in community practice. AJR Am J Roentgenol. 2016;206(1):211-6. doi: 10.2214/AJR.15.14356. PubMed
Onega T, Tosteson AN, Weiss J, Alford-Teaster J, Hubbard RA, Henderson LM, Kerlikowske K, Goodrich ME, O'Donoghue C, Wernli KJ, DeMartini WB, Virnig BA. Costs of diagnostic and preoperative workup with and without breast MRI in older women with a breast cancer diagnosis. BMC Health Serv Res. 2016 Feb 27;16(1):76. doi: 10.1186/s12913-016-1317-6. PubMed
Wernli KJ, Brenner AT, Rutter C, Inadomi J. Short-term risks associated with general anesthesia during colonoscopy compared to conscious sedation in US adult population. Gastroenterology. Epub 2015.
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