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
Wernli KJ, Brenner AT, Rutter CM, Inadomi JM. Risks associated with anesthesia services during colonoscopy. Gastroenterology. 2015 Dec 17. pii: S0016-5085(15)01813-2. doi: 10.1053/j.gastro.2015.12.018.[Epub ahead of print]. PubMed
Henderson LM, Miglioretti DL, Kerlikowske K, Wernli KJ, Sprague BL, Lehman CD. Breast cancer characteristics associated with digital versus film-screen mammography for screen-detected and interval cancers. AJR Am J Roentgenol. 2015 Sep;205(3):676-84. doi: 10.2214/AJR.14.13904.
Li W, Ray RM, Thomas DB, Davis S, Yost M, Breslow N, Gao DL, Fitzgibbons ED, Camp JE, Wong E, Wernli KJ, Checkoway H. Shift work and breast cancer among women textile workers in Shanghai, China. Cancer Causes Control. 2015 Jan;26(1):143-50. doi: 10.1007/s10552-014-0493-0. Epub 2014 Nov 25. PubMed
Gallagher LG, Li W, Ray RM, Romano ME, Wernli KJ, Gao DL, Thomas DB, Checkoway H. Occupational exposures and risk of stomach and esophageal cancers: update of a cohort of female textile workers in Shanghai, China. Am J Ind Med. 2015 Jan 21. doi: 10.1002/ajim.22412. [Epub ahead of print]. PubMed
Wieneke AE, Bowles EJ, Cronkite D, Wernli KJ, Gao H, Carrell D, Buist DS. Validation of natural language processing to extract breast cancer pathology procedures and results. J Pathol Inform. 2015 Jun 23;6:38. doi: 10.4103/2153-3539.159215. eCollection 2015. PubMed
Lee CI, Ichikawa L, Rochelle MC, Kerlikowske K, Miglioretti DL, Sprague BL, DeMartini WB, Wernli KJ, Joe BN, Yankaskas BC, Lehman CD. Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices. Acad Radiol. 2014 Nov;21(11):1370-6. doi: 10.1016/j.acra.2014.06.003. Epub 2014 Aug 7. PubMed
Tiro JA, Kamineni A, Levin TR, Schottinger JE, Zhen Y, Chubak J, Corley D, Doubeni C, Gupta S, Halm E, Skinner CS, Rutter C, Wernli KJ, Klabunde CN. The colorectal cancer screening process in community settings: a conceptual model for the Population-Based Research Optimizing Screening Through Personalized Regimens consortium Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1147-58. doi: 10.1158/1055-9965.EPI-13-1217. Epub 2014 Jun 10.
Wernli KJ, Hubbard RA, Johnson E, Chubak J, Kamineni A, Green BB, Rutter CM. Patterns of colorectal cancer screening uptake in newly-eligible men and women. Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1230-7. doi: 10.1158/1055-9965.EPI-13-1360. Epub 2014 May 3. PubMed
Johnson K, Kamineni A, Fuller S, Olmstead D, Wernli KJ. How the provenance of electronic health record data matters for research: a case example using system mapping. eGEMs. 2014;2(1):Article 4. Available from: http://repository.academyhealth.org/egems/vol2/iss1/4.
Cohen-Cline H, Wernli KJ, Bradford SC, Boles-Hall M, Grossman DC. Use of interactive voice response to improve colorectal cancer screening. Med Care. 2014 Jun;52(6):496-9. doi: 10.1097/MLR.0000000000000116. Epub 2014 Mar 15. 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