Karen J. Wernli, PhD

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“I consider patients the core of my research.”

Karen J. Wernli, PhD

Senior Scientific Investigator, Kaiser Permanente Washington Health Research Institute
Professor, Department of Health System Science, Kaiser Permanente Bernard J. Tyson School of Medicine
Affiliate Professor, Department of Epidemiology and Department of Health Systems and Population Health, University of Washington

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 approximately $30 million in research funding as principal investigator (PI) or site PI, more than 125 peer-reviewed publications (h-index 35), and more than 85 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. She is cancer care delivery research lead for the Kaiser Permanente Washington 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 Natasha Stout, PhD, 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 a project co-lead with Kaiser Permanente Southern California researcher Erin Hahn, PhD, MPH, and Veterans Affairs researcher Neetu Chawla, PhD, MPH, in an NCI-funded 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 Marlaine Figueroa Gray, PhD, 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 beyond oncology clinical trials. She is principal investigator of a multisite study of flu and COVID-19 vaccine effectiveness funded by the Centers for Disease Control and Prevention from 2022 to 2027. Her study team is annually enrolling about 1,200 participants with flu-like symptoms into her research.

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 an affiliate professor of epidemiology and health systems and population health at the University of Washington and a professor of health system science at the Kaiser Permanente Bernard J. Tyson School of Medicine.

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

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

Aiello Bowles EJ, Wernli KJ, Gray HJ, Bogart A, Delate T, O’Keefe-Rosetti M, Nekhylyudov L, Trice Loggers E. Diffusion of intraperitoneal chemotherapy in women with advanced ovarian cancer in community settings 2003-2008: the effect of the NCI clinical recommendation. Front Oncol. 2014 Mar 10;4:43. doi: 10.3389/fonc.2014.00043. eCollection 2014. PubMed

Onega T, Weiss J, Kerlikowske K, Wernli K, Buist DS, Henderson LM, Goodrich M, Alford-Teaster J, Virnig B, Tosteson AN, DeMartini W, Hubbard R. The influence of race/ethnicity and place of service on breast reconstruction for Medicare beneficiaries with mastectomy.  Springerplus. 2014 Aug 8;3:416. doi: 10.1186/2193-1801-3-416. eCollection 2014.  PubMed

Wernli KJ, DeMartini WB, Ichikawa L, Lehman C, Onega TL, Kerlikowske K, Gellar BM, Hofmann M, Yankaskas BC; for the Breast Cancer Surveillance Consortium. Patterns of breast magnetic resonance imaging use in community practice. JAMA Intern Med. 2014 Jan;174(1):125-32. doi: 10.1001/jamainternmed.2013.11963. Epub 2013 Nov 18. PubMed

Wernli KJ, O’Meara E, Kerlikowske K, Miglioretti D, Muller CY, Onega T, Sprague B, Henderson L, Buist DS. Investigation of mammographic breast density as a risk factor for ovarian cancer. J Nat Cancer Inst. 2014 Jan 1;106(1):djt341. doi: 10.1093/jnci/djt341. Epub 2013 Dec 5. PubMed

O'Meara ES, Zhu W, Hubbard RA, Braithwaite D, Kerlikowske K, Dittus KL, Geller B, Wernli KJ, Miglioretti DL. Mammographic screening interval in relation to tumor characteristics and false-positive risk by race/ethnicity and age. Cancer. 2013 Nov 15;119(22):3959-67. doi: 10.1002/cncr.28310. Epub 2013 Aug 26. PubMed

Li W, Ray RM, Thomas DB, Yost M, Davis S, Breslow N, Gao DL, Fitzgibbons ED, Camp JE, Wong E, Wernli KJ, Checkoway H. Occupational exposure to magnetic fields and breast cancer among women textile workers in Shanghai, China. Am J Epidemiol. 2013 Oct 1;178(7):1038-45. doi: 10.1093/aje/kwt161. Epub 2013 Sep 15. PubMed

Wernli KJ, Kitahara CM, Tamers SL, Al-Temimi MH, Braithwaite D. Undertaking cancer research in international settings: report from the American Society for Preventive Oncology Special Interest Group on International Issues in Cancer. Cancer Epidemiol Biomarkers Prev. 2013 Sep;22(9):1638-41. doi:10.1158/1055-9965.EPI-13-0655. Epub 2013 Jul 11. PubMed

Wernli KJ, Rutter CM, Dachman AH, Zafar HM. Suspected extracolonic neoplasms detected on CT colonography: literature review and possible outcomes. Acad Radiol. 2013 Jun;20(6):667-74. doi: 10.1016/j.acra.2013.01.017. Epub 2013 Mar 1. PubMed

Kerlikowske K, Zhu WW, Hubbard R, Gellar B, Dittus K, Braithwaite D, O’Meara E, Wernli KJ, Miglioretti D, for the Breast Cancer Surveillance Consortium. Outcomes of screening mammography by frequency, breast density and postmenopausal hormone therapy. JAMA Intern Med. 2013 May 13;173(9):807-16. doi:10.1001/jamainternmed.2013.307. Epub 2013 Mar 18. PubMed

 

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