As Director of Research in Shared Decision Making in the Division of General Medicine at BIDMC, Dr. Mara Schonberg's research focuses on understanding, improving, and implementing shared decision-making in care. Shared decision-making is a joint process between patients and clinicians where clinicians provide balanced and evidence-based information on an intervention, patients provide their perspective on the intervention based on a realistic understanding of the likely outcomes, and together they decide on a course of intervention. In her work, she has used qualitative research methods to understand patient and clinician perspectives related to a decision, has developed conversation aids and patient decision aids, and has implemented these tools in practice.
Breast cancer screening and treatment
Dr. Schonberg is passionate about helping women, especially older women, understand the possible benefits and harms of mammography screening. In her research, she has studied breast cancer screening rates in women based on their breast cancer risk and health and examined outcomes of screening in older women. Dr. Schonberg developed a decision aid informing women 75 and older on the benefits (e.g., a small reduction in breast cancer mortality, early detection, reassurance) and harms (e.g., overdetection, false alarms, and radiation exposure) of mammography screening to help support their screening decisions. She has also developed a conversation aid for clinicians to use to individualize mammography screening outcomes for older women to support shared decision-making during a vision. Finally, she has studied breast cancer characteristics, treatment, and survival in older women which led her to develop a breast cancer treatment decision aid for women aged 70 and older with Stage I, estrogen receptor-positive, HER2 negative, breast cancer. She has tested her mammography screening decision aid for women aged 75 and older in a large clinician-cluster level randomized controlled trial and found that it increases older women's knowledge of the benefits and harms of mammography screening and reduces overuse of mammography screening.
Decision-Making Tools:
Decide Together
ePrognosis - Geriatric Prognostic Indices
ePrognosis - Schonberg Index
Mammography Decision Aid - Women age 75-84
