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.
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
Comparative effectiveness research, health outcomes research, patient-centered outcomes, health care quality, implementation science
Cancer screening and surveillance
Patient engagement, stakeholder engagement, qualitative research methods, mixed-methods, human-centered design
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 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.
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
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, 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
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.
New research spotlights overdiagnosis, MRI before surgery, and a new way of predicting breast cancer risk
The VOICE study aims to improve the health and health care of people who had cancer as adolescents and young adults.
By partnering with patients, KPWHRI researchers developed 2 new interventions to boost lung cancer screening.
New study calculates risk-based approach to detect the most cancers with the fewest exams.
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.