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
Chubak J, McLerran D, Zheng Y, Singal AG, Corley DA, Doria-Rose VP, Doubeni CA, Kamineni A, Haas JS, Halm EA, Skinner CS, Zauber AG, Wernli KJ, Beaber EF. Receipt of colonoscopy following diagnosis of advanced adenomas: an analysis within integrated healthcare delivery systems. lid - 10.1158/1055-9965.epi-18-0452 [doi] Cancer Epidemiol Biomarkers Prev. 2018 Nov 20. pii: 1055-9965.EPI-18-0452. doi: 10.1158/1055-9965.EPI-18-0452 [Epub ahead of print] PubMed
Lee CI, Zhu W, Onega TL, Germino J, O’Meara ES, Lehman CD, Henderson LM, Haas JS, Kerlikowske K, Sprague BL, Rauscher GH, Tosteson ANA, Alford-Teaster J, Wernli KJ, Miglioretti DL. The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume. AJR Am J Roentgenol. 2018 Nov;211(5):957-963. Epub 2018 Sep 20.
Figueroa Gray M, Ludman EJ, Beatty T, Rosenberg AR, Wernli KJ. Balancing hope and risk among adolescent and young adult cancer patients with late-stage cancer: a qualitative interview study. J Adolesc Young Adult Oncol. 2018 Dec;7(6):673-680. doi: 10.1089/jayao.2018.0048. Epub 2018 Aug 10. PubMed
Greene SM, Brandzel S, Wernli KJ. From principles to practice: real-world patient and stakeholder engagement in breast cancer research. Perm J. 2018;22. pii: 17-232. doi: 10.7812/TPP/17-232. PubMed
Onega T, Zhu W, Weiss JE, Goodrich M, Tosteson ANA, DeMartini W, Virnig BA, Henderson LM, Buist DSM, Wernli KJ, Kerlikowske K, Hubbard RA. Preoperative breast MRI and mortality in older women with breast cancer. Breast Cancer Res Treat. 2018 Mar 7. pii: 10.1007/s10549-018-4732-z. doi: 10.1007/s10549-018-4732-z. [Epub ahead of print]. PubMed
Singal AG, Corley DA, Kamineni A, Garcia M, Zheng Y, Doria-Rose PV, Quinn VP, Jensen CD, Chubak J, Tiro J, Doubeni CA, Ghai NR, Skinner CS, Wernli K, Halm EA. Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States. 2018 May;113(5):746-754. doi: 10.1038/s41395-018-0023-x. Epub 2018 Feb 27. PubMed
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
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