About

Contact us

This website was developed by a team of researchers led by Drs. Mara Schonberg and Natasha Stout. We welcome your comments and questions. Please email Dr. Schonberg (mschonbe@bidmc.harvard.edu) with comments and/or suggestions.

Information for clinicians on using this site

This website is designed to support shared decision making around mammography screening between clinicians and women ages 75 and older. This site has several components:

1. The conversation aid

This conversation aid uses information on a woman’s age, health, prior mammography use, breast density, family history of breast cancer, and prior breast biopsies (see health questions) to individualize the outcomes of mammography screening for women ages 75 to 89.

The conversation aid is designed to be used during fast-paced office visits. Therefore, this site will provide information on 10-year outcomes of mammography screening if only information on a woman’s age is input and not the other factors. In these cases, the information provided is based on the average woman that age.

The conversation aid allows users to see 10-year outcomes if a woman continues to be screened with mammography or stops screening. The user may choose to compare if a woman is screened every year for 10 years, every other year for 10 years, or just one more time, with stopping screening.

The conversation aid presents 10-year outcomes if screened or not screened for: breast cancer incidence, breast cancer death, death overall, chance of overdetection, chance of late-stage breast cancer, and false alarm tests.

The life expectancy tab provides an estimate of a woman’s life expectancy based on the input risk factors.

The decision tab of the conversation aid is designed to help women and their clinicians assess which way they are leaning regarding mammography screening.

Clinicians may also print a summary that patients could take home with information presented in the conversation aid.

The information on outcomes of screening are derived from simulation models created by the NCI-sponsored Cancer Intervention and Surveillance Modeling Network (CISNET). Please see the references page for more information.

Watch a short video describing the site’s features and how to use it with patients:

2. Clinician talking points

This section of the site provides talking points and strategies for clinicians to use to engage women 75 and older in shared decision making around mammography screening.

3. EMR documentation

This site provides example text that may be cut and pasted into electronic medical records to help document shared decision making conversations about mammography screening with women 75 and older.

Decide Together team

Mara A. Schonberg, MD, MPH

Department of Medicine, Harvard Medical School, Cambridge, Massachusetts Department of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA

Natasha K. Stout, PhD

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

Russell Harris, MD, MPH

University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.

Jinani C. Jayasekera, PhD

Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

Jeanne Mandelblatt, MD, MPH

Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

Daniel D. Matlock, MD, MPH

Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA

Victor M. Montori, MD, MSc

Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA

Ilana B. Richman, MD

Department of Medicine, Yale School of Medicine, New Haven, CT, USA

Clyde B. Schechter, MD, MA

Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

Nancy L. Schoenborn, MD, MHS

Division of Geriatric Medicine and Gerontology, School of Medicine, John Hopkins University, Baltimore, MD, USA

Elizabeth Gilliam, MA

Department of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA

Jessica Jushchyshyn

Department of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA

With the additional help and support of expert stakeholders, including: Dejana Braithwaite, PhD, MS; Tamara Cadet, PhD, MSW; Angela Fagerlin, PhD; David Ives, MD; Nancy Keating, MD, MPH; Janie Lee, MD, MSc; Rosanne Leipzig, MD, PhD; Barbara LeStage, MHP; (Cancer Patient Advocate); Daniel Moran, MSN, APRN; Brooke Salzman, MD; Louise Walter, MD; and Christopher Zahn, MD.

We also want to thank the Dana-Farber/Harvard Cancer Center’s Health Communication Core (HCC) for their work in designing and developing this website. HealthCommCore.org

Thanks also to Cast Iron Coding for their help in developing this website.