Dr. Karen Wernli, Senior Scientific Investigator at Kaiser Permanente Washington Health Research Institute, delves into the intersection of epidemiology and personalized medicine, exploring the challenges of balancing population-level research with individualized healthcare needs. She discusses survivorship in breast cancer with a comparison of mammograms vs. MRIs for surveillance imaging. Dr. Wernli talks about some of the challenges patients face throughout the breast cancer diagnosis and treatment process, emphasizing the importance of including the patient voice in research to capture those lived experiences.

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Key Highlights:

About our guest:

Karen Wernli, PhD, is a Senior Scientific Investigator at Kaiser Permanente Washington Health Research Institute and Professor in the Department of Health System Science at Kaiser Permanente Bernard J. Tyson School of Medicine. She is a cancer epidemiologist and health services researcher whose work focuses on incorporating patient-centered outcomes to improve health care along the cancer care continuum, from prevention to survivorship. Her work spans several types of cancer (including breast and lung), and explores the impact of cancer in special populations (adolescents and young adults with cancer). Her research strives to answer critical questions at the confluence of patients’ needs and clinical priorities.

Key Moments:

18 minutes: On the importance of reporting data for subgroups even if it is a small number. “If you only had 5 people in a subgroup, doing complex math about relationships is impossible. But at least I can describe what's going on. At least you could see what's the distribution of the exposure, the outcome of something I'm studying? So that we start to understand what's going on in this population when we don't have any other data."

52 minutes: Looking at surveillance using Mammogram vs. MRI. “Our study found that using breast MRI resulted in twice as many biopsies. What that means is if you did it on a population level, there would be thousands, like tens of thousands of additional women having a breast biopsy. And that if you waited another six months, the mammogram likely would have caught the cancer and maybe would not have changed the course of what was actually happening.”

This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this PCORI study by Karen Wernli, PhD.

The perspective shared is solely the responsibility of Dr. Wernli and does not necessarily represent the official views of the Patient Centered Outcomes Research Institute or Kaiser Permanente.

Limitations: Please note the investigators suggest that the multivariate analysis could not adjust for all population characteristics in this observational study. This means that the interpretation of the results from the study is complex. Since we are a podcast that does not provide medical advice, please discuss with your clinician which imaging is recommended for you.

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