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

Buist DSM, Abraham L, Lee CI, Lee JM, Lehman C, O'Meara ES, Stout NK, Henderson LM, Hill D, Wernli KJ, Haas JS, Tosteson ANA, Kerlikowske K, Onega T. Breast biopsy intensity and findings following breast cancer screening in women with and without a personal history of breast cancer. JAMA Intern Med. 2018 Feb 12. pii: 2672204. doi: 10.1001/jamainternmed.2017.8549. [Epub ahead of print]. PubMed

Miles R, Wan F, Onega TL, Lenderink-Carpenter A, O'Meara ES, Zhu W, Henderson LM, Haas JS, Hill DA, Tosteson ANA, Wernli KJ, Alford-Teaster J, Lee JM, Lehman CD, Lee CI. Underutilization of supplemental magnetic resonance imaging screening among patients at high breast cancer risk. J Womens Health (Larchmt). 2018 Jan 17. doi: 10.1089/jwh.2017.6623. [Epub ahead of print]. PubMed

Henderson LM, Hubbard RA, Zhu W, Weiss J, Wernli KJ, Goodrich ME, Kerlikowske K, DeMartini W, Ozanne EM, Onega T. Preoperative breast magnetic resonance imaging use by breast density and family history of breast cancer. J Womens Health (Larchmt). 2018 Jan 15. doi: 10.1089/jwh.2017.6428. [Epub ahead of print]. PubMed

Roth JA, Carter-Harris L, Brandzel S, Buist DSM, Wernli KJ. A qualitative study exploring patient motivations for screening for lung cancer. PLoS One. 2018 Jul 5;13(7):e0196758. doi: 10.1371/journal.pone.0196758. eCollection 2018. PubMed

Hill DA, Haas JS, Wellman R, Hubbard RA, Lee CI, Alford-Teaster J, Wernli KJ, Henderson LM, Stout NK, Tosteson ANA, Kerlikowske K, Onega T. Utilization of breast cancer screening with magnetic resonance imaging in community practice. J Gen Intern Med. 2018 Mar;33(3):275-283. doi: 10.1007/s11606-017-4224-6. Epub 2017 Dec 6. PubMed

Onega T, Weiss JE, Goodrich ME, Zhu W, DeMartini WB, Kerlikowske K, Ozanne E, Tosteson ANA, Henderson LM, Buist DSM, Wernli KJ, Herschorn SD, Hotaling E, O'Donoghue C, Hubbard R. Relationship between preoperative breast MRI and surgical treatment of non-metastatic breast cancer. J Surg Oncol. 2017 Dec;116(8):1008-1015. doi: 10.1002/jso.24796. Epub 2017 Nov 11. PubMed

Sakoda LC, Henderson LM, Caverly TJ, Wernli KJ, Katki HA. Applying risk prediction models to optimize lung cancer screening: current knowledge, challenges, and future directions. Curr Epidemiol Rep (2017). https://doi.org/10.1007/s40471-017-0126-8.

Lee JM, Ichikawa L, Valencia E, Miglioretti DL, Wernli K, Buist DSM, Kerlikowske K, Henderson LM, Sprague BL, Onega T, Rauscher GH, Lehman CD. Performance benchmarks for screening breast MR imaging in community practice. Radiology. 2017 Oct;285(1):44-52. doi: 10.1148/radiol.2017162033. PubMed

Sethi R, Buchlak QD, Yanamadala V, Anderson ML, Baldwin EA, Mecklenburg RS, Leveque JC, Edwards AM, Shea M, Ross L, Wernli KJ. A systematic multidisciplinary initiative for reducing the risk of complications in adult scoliosis surgery. J Neurosurg Spine. 2017 Mar 31:1-7. doi: 10.3171/2016.11.SPINE16537. [Epub ahead of print]. PubMed

Balasubramanian BA, Garcia MP, Corley DA, Doubeni CA, Haas JS, Kamineni A, Quinn VP, Wernli K, Zheng Y, Skinner CS. Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems. Medicine (Baltimore). 2017;96(11):e6326. doi: 10.1097/MD.0000000000006326. PubMed

 

Research

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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.