Professional Documents
Culture Documents
Health
In 2006, UpToDate began grading recom- Why doesn’t UpToDate grade diagnostics?
mendations using the GRADE format. This is a UpToDate only grades recommendations about
continuing process, with thousands of graded treatment or screening because we feel that
recommendations in the program. Graded no existing system for grading diagnostic
recommendations appear in the Summary and recommendations works well enough to be
Recommendations sections of each topic. useful to clinicians. Rather than grade
diagnostic recommendations, UpToDate
UpToDate dedicates considerable resources describes the evidence underlying such
to ensuring that our recommendations are recommendations in the text of the topic.
clear, complete, and correct. In addition to UpToDate is participating in efforts to come
our routine peer review process, our Co- up with a clinically useful system for grading
Executive Editor and/or Deputy Editors review diagnostic recommendations.
all assigned grades to confirm that they
accurately reflect the quality of the evidence How often is UpToDate content updated?
and the strength of the recommendation. In UpToDate is updated daily following a continual
addition, Dr. Guyatt comes to Massachusetts comprehensive review of the resources listed
regularly to continue to educate our physician on the second page (peer-reviewed journals,
editors about evidence-based medicine clinical databases, etc.). Topics in UpToDate are
and grading. revised whenever important new information
is published, not according to any specific time
It is important to understand the difference schedule. Updates are integrated carefully,
between grading evidence and grading after extensive peer review, with specific
recommendations. UpToDate does both, statements as to how the new findings should
which makes it unique among point-of-care be applied to clinical practice.
resources, which typically grade only the quality
of evidence or even just individual studies. Updates that are deemed particularly important
However, there are occasions when strong by our authors and editors (i.e., those that
recommendations may be made in the face of may change practice, drug alerts, etc.) are
low-quality evidence, or weak recommendations highlighted in our “What’s New” section and a
in the face of high-quality evidence. For example: subset that are considered practice-altering
are featured in our “Practice Changing
Weak recommendations with high-quality UpDates” section.
evidence occur when individual patient values
and preferences make a decision a close call.
For example, we have high-quality evidence
1. Guyatt, GH, Rennie, D, Meade, MO, Cook, DJ. Users’ Guides to
that lifelong anticoagulation after idiopathic the Medical Literature: A Manual for Evidence-based Clinical
DVT reduces the risk of recurrence, but many Practice, 2nd ed, McGraw-Hill, New York 2008.
patients are unwilling to accept the ongoing 2. http://www.gradeworkinggroup.org.
US/CAN: tel 1.800.998.6374 | All other countries: tel +1 781.392.2000
Please visit www.uptodate.com for more information.
©2018 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved
03.18 | SKU #000236 IM&S