Current Research at the Behavioral and Clinical Outcomes Research Program
Survivorship and Late Effects
Tracking and reducing long-term side effects of therapy through prevention and intervention.
Investigators
Tyler Ketterl, MD, MS
Assistant Professor
Bio: Tyler G. Ketterl, MD, MS is an attending physician at Seattle Children’s Hospital and Assistant Professor at the University of Washington School of Medicine. Dr. Ketterl is the Medical Director of the Adolescent and Young Adult Oncology Program. Dr. Ketterl holds triple board certifications in Internal Medicine, Pediatrics and Pediatric Hematology/Oncology. He completed his Internal Medicine and Pediatrics Residency at the University of Minnesota, Pediatric Hematology/Oncology fellowship at the University of Washington, and his Masters in Science in Epidemiology with a focus on clinical research methods at the University of Washington. In July of 2018, Dr. Ketterl joined the faculty at Seattle Children’s Hospital and the University of Washington. Dr. Ketterl’s work currently focuses on the long-term impact of cancer therapy on adolescent and young adult survivors of cancer. Of particular interest to Dr. Ketterl is developing interventions that could prevent early morbidity and mortality from type 2 diabetes and cardiovascular disease in adolescent and young adult survivors of cancer. Dr. Ketterl also has interest and expertise in germ cell tumors and fertility preservation methods.
Research interests: Long-term impact of cancer therapy on adolescent and young adult survivors of cancer, metabolic syndrome, sarcopenic obesity, exercise interventions for cancer survivors, risk-behavior screening in AYA cancer patients
Kasey Leger, MD, MSc
Associate Professor
Bio: My research focus on cardiotoxicity centers largely on early biomarkers of anthracycline-induced cardiac injury and cardiomyopathy risk prediction. Additionally, I am committed to optimizing strategies of cardioprotection, primary and ultimately secondary wherein validated risk prediction models are critical. I lead the Children’s Oncology Group (COG) Myeloid Cardiotoxicity Working Group and am the cardiac chair of the ongoing COG Phase III randomized trial for patients with de novo AML comparing standard therapy to CPX-351 (AAML1831). This large, multi-institutional trial will assess strategies to mitigate cardiotoxicity and leverage a large, high-risk cohort to capture detailed cardiac phenotyping by echocardiographic measures of cardiac function and mechanics and circulating biomarkers of cardiac injury and stress. Additionally, I am the principal investigator of a cardiotoxicity biomarker cohort study at Seattle Children’s in which we are studying circulating microRNAs, high sensitivity troponin, myocardial deformation imaging (strain), and other novel blood and imaging based markers of cardiotoxicity.
Research interest: Early identification and prevention of cancer therapy-induced cardiovascular disease
Rebecca Ronsley, MD, FRCPC
Assistant Professor of Pediatrics
Bio: Dr. Ronsley completed her Bachelor of Science in Anatomy and Cell Biology at McGill University and her Medical Degree at the University of Toronto. Subsequently, she completed Pediatrics Residency, Pediatric Endocrinology training and Pediatric Hematology, Oncology & Bone Marrow Transplant Fellowship at the University of British Columbia, followed by a Fellowship in Pediatric Neuro-Oncology at Nationwide Children’s Hospital in Columbus, Ohio. She is an Attending Physician and Pediatric Oncologist in the Brain Tumor Program at Seattle Children’s Hospital. She is the Program Director for the Pediatric Neuro-Oncology Fellowship and Education Lead for the Brain Tumor Program at Seattle Children’s Hospital. She is a Clinician Scholar and is involved with local (including our BrainChild/CAR-T trials) and national trials to develop novel therapies for difficult-to-treat pediatric brain tumors. Dr. Ronsley is also passionate about morbidity reduction for survivors of pediatric CNS tumors and collaborates locally and nationally within the Childhood Cancer Survivorship Study and the International CNS Germ Cell Tumor Consortium.
Research interests: Metabolic and endocrine comorbidities and infertility/gonadal failure in survivors of pediatric brain tumors
David Noyd, MD, MSCE
Contact us: For questions or inquiries, email: [email protected]
Psychosocial Outcomes and Supportive Care
Understanding the psychosocial landscape of cancer and developing interventions to improve quality of life for patients and families.
Current projects
- Addressing social needs of adolescents and young adults with cancer
- Social health among adolescent and young adult cancer survivors
- Evaluation of psychosocial mobile health interventions during cancer care for adolescents
- Development of a financial toxicity outcome measure in pediatric oncology
- Evaluating the effects of financial navigation among young adult survivors of cancer
Investigators
Kaitlyn Fladeboe, PhD
Assistant Professor
Bio: Dr. Kaitlyn (Katy) Fladeboe is a developmental psychologist and assistant professor in the University of Washington Department of Pediatrics and the Ben Towne Center for Childhood Cancer and Blood Disorders Research at Seattle Children’s Research Institute. Dr. Fladeboe grew up in the San Francisco Bay Area and earned her bachelor's degree in psychology at the University of California Santa Barbara. She then moved to Washington where she completed her PhD in developmental psychology at the University of Washington and postdoctoral fellowship at Seattle Children’s Research Institute. Applying principles of developmental science, Dr. Fladeboe's research aims to identify and address the unique psychological and social needs of youth with cancer and their families.
Research interests: Adolescent and young adult (AYA) psychosocial oncology; social relationships and health; behavioral intervention design
Kristine Karvonen, MD, MS
Assistant Professor
Bio: Dr. Kristine Karvonen is a pediatric hematologist/oncologist and investigator with a research focus on social drivers of racial and ethnic inequities, including racism and social determinants of health. Dr. Karvonen plans to deploy community-engaged interventions to improve the experience of all patients and families from marginalized racial and ethnic groups and to correct outcome inequities. Dr. Karvonen received her medical degree at University of Virginia, residency and fellowship at University of Washington, and additional training in health equity at the Child Health Equity Research Program for Postdoctoral Fellows (CHERPP-T) and master in science in epidemiology with a focus on clinical and translational research at the University of Washington. She is an attending physician in the Center for Cancer and Blood Disorders with a focus in oncology and sickle cell disease.
Research interests: Reducing variations in health outcomes and access across communities, pediatric oncology
Nancy Lau, PhD
Assistant Professor
Bio: Dr. Nancy Lau is a clinical psychologist and assistant professor in the University of Washington Department of Psychiatry and Behavioral Sciences and the Center for Child Health, Behavior and Development. Dr. Lau grew up in the Bay Area in California and completed her BA in psychology at the University of California Berkeley. After that, she moved to Boston and received her MA and PhD in clinical psychology from Harvard University. She then moved back to the west coast (which feels like home) to completed her psychology residency training at the University of Washington and Seattle Children's Hospital, followed by an NIH-funded T32 postdoctoral research fellowship in pediatric palliative care at the University of Washington. Dr. Lau’s research focuses on the development, testing, and implementation of digital mental health interventions for teens and young adults with cancer.
Research interests: Psychosocial oncology, mental health interventions, mobile/digital health, implementation science
Emily Merkel, MD
Clinical Fellow
Bio: Dr. Emily Merkel is a fellow in pediatric hematology and oncology at Seattle Children's Hospital/University of Washington with clinical and research interests at the intersection of bone marrow transplant and palliative care. After studying at Barnard College in New York, Dr. Merkel spent several years in rural Rwanda working for Partners in Health, a healthcare and social justice NGO. It was there while contributing to what later became Rwanda's national cancer program that she developed a passion for oncology and palliative care. She attended medical school in Seattle at the University of Washington, completed residency in pediatrics at the Children's Hospital of Philadelphia, and returned to Seattle for fellowship in pediatric hematology and oncology with additional training in epidemiology through an MS at the University of Washington. She is currently completing an additional fellowship in palliative care at the University of Washington.
Research interests: Bone marrow transplant (BMT), palliative care, patient reported outcomes, communication
Tim Ohlsen, MD, MS
Assistant Professor
Bio: Dr. Ohlsen is a pediatric oncologist and researcher interested in examining and alleviating financial toxicity — the financial challenges that patients and families face as a result of their cancer. He also conducts research related to the impact of geography on patient outcomes, comparative effectiveness, and the prevention of late effects of treatment. Dr. Ohlsen earned his medical degree from the University of Pittsburgh School of Medicine before completing a residency in pediatrics at the University of Utah. He then completed fellowship training in pediatric hematology/oncology at the University of Washington/Seattle Children's Hospital, including research training through the Health Services and Quality of Care integrated fellowship. Clinically, he cares for children with cancer and blood disorders with a focus on solid tumors.
Research interests: Financial toxicity, area-based measures, patient-reported outcomes, prevention of late effects
Contact us: For questions or inquiries, email: [email protected]
Health Services and Quality Improvement
Studying effective and evidence-based cancer care delivery through a systems-oriented lens.
Current projects
- Improving sepsis detection in acute care oncology settings
- Quality improvement in acute fever and neutropenia management in outpatient settings
- Cost-effectiveness of oncology supportive care strategies
- Linking data elements from the medical record to state cancer registries
Investigators
David Noyd, MD, MSCE
Tim Ohlsen, MD, MS
Acting Instructor
Bio: Dr. Ohlsen is a pediatric oncologist and researcher interested in examining and alleviating financial toxicity—the financial challenges that patients and families face as a result of their cancer. He also conducts research related to geographic disparities, economic analysis, and oncology supportive care. Dr. Ohlsen earned his medical degree from the University of Pittsburgh School of Medicine before completing a residency in pediatrics at the University of Utah. He then completed fellowship training in pediatric hematology/oncology at the University of Washington & Seattle Children's Hospital. Clinically, he cares for children with cancer and blood disorders with a focus on solid tumors.
Research interests: Financial toxicity, geographic disparities, measure development
Jen Wilkes, MD, MSCE
Contact us: For questions or inquiries, email: [email protected]
Improving Health Outcomes and Access to Care
Ensuring that all patients and families have fair access to care and opportunities to thrive.
Current projects
- Impact of redlining on cancer outcomes
- Family experiences with racism during pediatric cancer treatment
- Incorporating social determinants of health into early phase clinical trials and cellular immunotherapy
- Impact of rural residence and neighborhood deprivation on hospital utilization
- Language-related challenges in healthcare
Investigators
Anurekha Hall, MD, MS
Assistant Professor
Bio: Dr. Hall is a pediatric oncologist at Seattle Children’s Hospital and assistant professor at the University of Washington School of Medicine. She grew up in the Bay Area, received her undergraduate degree in biology from Northwestern University and then moved to Phoenix to teach second grade for two years through Teach for America. She received her medical degree from the University of Toledo College of Medicine, completed her pediatrics residency at Stanford University and moved to Seattle to complete her pediatric hematology oncology fellowship. Dr. Hall is a pediatric oncologist in the Cancer and Blood Disorders Center and the quality medical director of the Immune Effector Cell Program. She primarily cares for children being treated for leukemia or lymphoma and for children receiving chimeric antigen receptor T (CAR-T) cell therapies. Her research focuses on barriers in pediatric oncology, with a particular interest in variations in access to, and outcomes in, advanced therapies that are only offered at limited sites, such as CAR-T cells and phase 1 clinical trials.
Research interests: Improving healthcare experiences and outcomes, specifically in access to advanced treatment modalities only offered at limited sites
Kristine Karvonen, MD, MS
Assistant Professor
Bio: Dr. Kristine Karvonen is a pediatric hematologist/oncologist and investigator with a research focus on social drivers of racial and ethnic inequities. Dr. Karvonen plans to deploy community-engaged interventions toreduce variations in health outcomes across historically marginalized communities. Dr. Karvonen received her medical degree at the University of Virginia and completed a pediatrics residency, pediatric hematology and oncology fellowship, child health equity fellowship, and master of science degree in epidemiology at the University of Washington. She is an attending physician in the Center for Cancer and Blood Disorders with a focus in oncology and sickle cell disease.
Research interests: Reducing variations in health outcomes and access across communities, pediatric oncology
Melissa Martos, MD
Clinical Fellow
Bio: Dr. Martos is a pediatric oncology fellow, as well as a Health Services and Quality of Care research fellow. She is investigating gaps in oncology communication based on patient language of care. She ultimately aims to partner with families to research interventions that improve quality of communication, including for those that prefer a language other than English. Dr. Martos studied environmental science at UC Berkeley prior to earning her medical degree at UC San Francisco. She then completed pediatrics residency at the University of Washington/Seattle Children's Hospital and has continued on for fellowship. Her prior work includes improving healthcare experiences and outcomes for all patients and families.
Research interests: Communication, language, quality improvement
Tim Ohlsen, MD, MS
Assistant Professor
Bio: Dr. Ohlsen is a pediatric oncologist and researcher interested in examining and alleviating financial toxicity — the financial challenges that patients and families face as a result of their cancer. He also conducts research related to the impact of geography on patient outcomes, comparative effectiveness and the prevention of late effects of treatment. Dr. Ohlsen earned his medical degree from the University of Pittsburgh School of Medicine before completing a residency in pediatrics at the University of Utah. He then completed fellowship training in pediatric hematology/oncology at the University of Washington/Seattle Children's Hospital, including research training through the Health Services and Quality of Care integrated fellowship. Clinically, he cares for children with cancer and blood disorders with a focus on solid tumors.
Research interests: Financial toxicity, area-based measures, patient-reported outcomes, prevention of late effects
Contact us: For questions or inquiries, email: [email protected]
Communication and Bioethics
Studying how language and communication can improve health outcomes and care delivery.
Current projects
- Communication in genetic testing
- Design of a genetic testing communication toolkit
- Symptoms and health related quality of life following hemopoietic cell transplantation
- Impact of palliative care in pediatric hemopoietic cell transplantation
- Therapeutic implications of patient language of care in pediatric oncology
Investigators
Brittany Greene, MD, MA
Assistant Professor
Bio: Dr. Brittany Greene grew up in a suburb of Chicago then moved to Los Angeles to complete her undergraduate degree in French at UCLA. She matriculated from Duke University School of Medicine then moved to Seattle for her pediatrics residency at Seattle Children's Hospital/University of Washington. She stayed in Seattle for her pediatric hematology/oncology fellowship training, as well as a clinical bioethics fellowship and master of arts in bioethics at the University of Washington. She continues at Seattle Children's Hospital, where she is an attending physician in the Cancer and Blood Disorders Center, with a primary focus on solid tumors, and on the bioethics consult team, and serves as the Director of Ethics of the Cancer and Blood Disorders Program. Her research in the Ben Towne Center for Childhood Cancer and Blood Disorders Research focuses on the intersection of communication and bioethical issues in pediatric oncology.
Research interests: Bioethics, palliative care, ethical, legal, and social implications (ELSI) of genetic testing
Melissa Martos, MD
Fellow
Bio: Dr. Martos is a pediatric oncology fellow, as well as a Health Services and Quality of Care research fellow. She is investigating disparities in oncology communication based on patient language of care. She ultimately aims to partner with community groups to research interventions that improve quality of care for those that prefer a language other than English. Dr. Martos studied environmental science at UC Berkeley prior to earning her medical degree at UC San Francisco. She then completed pediatrics residency at the University of Washington/Seattle Children's Hospital and has continued on for fellowship. Her prior work includes clinic management and improvement and health equity education.
Research interests: Language equity, communication, quality improvement
Emily Merkel, MD
Clinical Fellow
Bio: Emily Merkel completed her fellowship in pediatric hematology and oncology at Seattle Children's Hospital/University of Washington with clinical and research interests at the intersection of bone marrow transplant and palliative care. After studying at Barnard College in New York, Dr. Merkel spent several years in rural Rwanda working for Partners in Health, a healthcare and social justice NGO. It was there while contributing to what later became Rwanda's national cancer program that she developed a passion for oncology and palliative care. She attended medical school in Seattle at the University of Washington, completed residency in pediatrics at the Children's Hospital of Philadelphia, and returned to Seattle for fellowship in pediatric hematology and oncology with additional training in epidemiology, completing an MS at the University of Washington. She is currently completing an additional fellowship in palliative care at the University of Washington.
Research interests: Bone marrow transplant (BMT), palliative care, patient reported outcomes, communication
Contact us: For questions or inquiries, email: [email protected]