Karen J. Wernli, PhD

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“I consider patients the core of my research.”

Karen J. Wernli, PhD

Associate Investigator, Kaiser Permanente Washington Health Research Institute

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 more than $15.5 million in external research funding, over 115 peer-reviewed publications, and more than 70 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. The purpose of the pilot grant is to develop a larger project within the 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 Dr. Natasha Stout 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 currently a project co-lead with Kaiser Permanente Southern California researcher Dr. Erin Hahn and Veterans Affairs researcher Dr. Neetu Chawla in an NCI-funded program 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 Dr. Marlaine Figueroa Gray, 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. She is currently the Cancer Care Delivery Research lead at Kaiser Permanente Washington. She is also principal investigator for KPWA of a multisite study of flu and COVID vaccine effectiveness funded by the Centers for Disease Control and Prevention.

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 a standing reviewer for the American Cancer Society, and routinely reviews grants for the National Institutes of Health. She is also an affiliate associate professor of population and epidemiology at the University of Washington.

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

Haas CB, Nekhlyudov L, Lee JM, Javid SH, Bush M, Johnson D, Gleason T, Kaufman C, Specht J, Stitham S, Wernli KJ. Surveillance for second breast cancer events in women with a personal history of breast cancer using breast MRI: a systematic review and meta-analysis. Breast Cancer Res Treat. 2020;181(2):255-268. doi: 10.1007/s10549-020-05637-y. Epub 2020 Apr 17. PubMed

Warner ET, Kennedy M, Maschke A, Hopkins MF, Wernli K, Gunn CM. Evaluation of existing patient educational materials and development of a brochure for women with dense breasts. Breast. 2020;50:81-84. doi: 10.1016/j.breast.2020.02.001. Epub 2020 Feb 5. PubMed

Mahorter SS, Knerr S, Bowles EJA, Wernli KJ, Gao H, Schwartz MD, O'Neill SC. Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial. Cancer. 2020 Apr 15;126(8):1614-1621. doi: 10.1002/cncr.32711. Epub 2020 Jan 24. PubMed

Schifferdecker KE, Tosteson ANA, Kaplan C, Kerlikowske K, Buist DSM, Henderson LM, Johnson D, Jaworski J, Jackson-Nefertiti G, Ehrlich K, Marsh MW, Vu L, Onega T, Wernli KJ. Knowledge and perception of breast density, screening mammography, and supplemental screening: in search of "informed". J Gen Intern Med. 2019 Dec 2. pii: 10.1007/s11606-019-05560-z. doi: 10.1007/s11606-019-05560-z. [Epub ahead of print]. PubMed

Henderson LM, Ichikawa L, Buist DSM, Lee JM, Bush M, Johnson D, Onega T, Nekhlyudov L, Kerlikowske K, Miglioretti DL, Sprague BL, Wernli KJ. Patterns of breast imaging use among women with a personal history of breast cancer. J Gen Intern Med. 2019 Oct;34(10):2098-2106. doi: 10.1007/s11606-019-05181-6. PubMed

Wernli KJ, Brandzel SD, Buist DM, Bush M, DeMartini W, Ichikawa L, Haas C, Henderson LM, Johnson D, Kerlikowske K, McColgin D, Miglioretti DL, Nekhlyudov L, Onega T, Rosenberg DE. Is breast MRI better at finding second breast cancers than mammograms alone for breast cancer survivors? Washington (DC): Patient-Centered Outcomes Research Institute(PCORI); 2019 May. PubMed

Kerlikowske K, Sprague BL, Tosteson ANA, Wernli KJ, Rauscher GH, Johnson D, Buist DSM, Onega T, Henderson LM, O'Meara ES, Miglioretti DL. Strategies to identify women at high risk of advanced breast cancer during routine screening for discussion of supplemental imaging. JAMA Intern Med. 2019 Jul 1. pii: 2737320. doi: 10.1001/jamainternmed.2019.1758. [Epub ahead of print]. PubMed

Wernli KJ, Ichikawa K, Kerlikowske K, Buist DSM, Brandzel SD, Bush M, Johnson D, Henderson LM, Nekhlyudov L, Onega T, Sprague BL, Lee JM, Lehman C, Miglioretti DL. Surveillance breast MRI and mammography performance measures in women with a personal history of breast cancer. Radiology. 2019 Aug;292(2):311-318. doi: 10.1148/radiol.2019182475. Epub 2019 Jun 4. PubMed

Wernli KJ, Ichikawa L, Kerlikowske K, Buist DSM, Brandzel SD, Bush M, Johnson D, Henderson LM, Nekhlyudov L, Onega T, Sprague BL, Lee JM, Lehman CD, Miglioretti DL. Surveillance breast MRI and mammography: comparison in women with a personal history of breast cancer. Radiology. 2019 Aug;292(2):311-318. doi: 10.1148/radiol.2019182475. Epub 2019 Jun 4. PubMed

Breen N, Skinner CS, Zheng Y, Inrig S, Corley DA, Beaber EF, Garcia M, Chubak J, Doubeni C, Quinn VP, Haas JS, Li CI, Wernli KJ, Klabunde CN. Time to follow-up after colorectal cancer screening by health insurance type. Am J Prev Med. 2019;56(5):e143-e152. doi: 10.1016/j.amepre.2019.01.005. PubMed

 

Research

illustration nurse and patient mammogram

Roundup of 3 recent studies on breast cancer screening

New research spotlights overdiagnosis, MRI before surgery, and a new way of predicting breast cancer risk

VOICE STUDY

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Understanding young adults’ experiences with cancer

The VOICE study aims to improve the health and health care of people who had cancer as adolescents and young adults.

Co-designing with patients

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Patient collaboration sparks care innovations

By partnering with patients, KPWHRI researchers developed 2 new interventions to boost lung cancer screening.

Cancer screening

An older woman stands in front of a mammography machine, preparing for her scan

Catching breast cancers when mammograms are limited

New study calculates risk-based approach to detect the most cancers with the fewest exams.

healthy findings blog

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Which women are receiving MRI to screen for breast cancer?

An epidemiologist identifies who is appropriately undergoing this imaging for breast cancer and who is not.

healthy findings blog

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Lung cancer screening guidelines are changing

Now’s the time, Dr. Wernli says, to weigh in on lowering eligible age and pack-years smoked.