UpToDate 14.1 has been released and users will not start to see topics with "graded" recommendations. This is in response to a subscriber survey which indicated evidence grading was desirable.

The grading system was developed in with UpToDate's Evidence Based Medicine Advisory Group. Currently only a few of the topics have grades (150), and the recommendations are found in the Summary and Recommendations section. Grades are comprised of two components: a number and a letter. The number (1 or 2) reflects whether it is a strong or weak recommendation, and the letter (A, B, or C) reflects the quality of the supporting evidence of the topic. The grading is subjective and based on the clinical expertise of authors, editors, and peer reviewers. However, they encourage feedback regarding the grading system or about a specific graded recommendation on a topic.

1 = Strong Recommendation, "We recommend..." -Benefits clearly outweigh the
risks and the burdens (or vice versa) for most, if not all patients
2 = Weaker Recommendation, "We suggest..." -Benefits and risks closely
balanced and/or uncertain

A = High Quality of Evidence -Consistent evidence from randomized trials,
or overwhelming evidence of some other form
B = Moderate Quality Evidence - Evidence from randomized trials with
important limitations, or very strong evidence of some other form
C - Low Quality Evidence - Evidence from observational studies,
unsystematic clinical observations, or from randomized trials with serious
flaws

In addition to their new grading system, UpToDate offers two new educational courses for CME; Using UpToDate for Evidence Based Answers at the Point of Care (a case based interactive session designed to train medical staff on how to use UpToDate) and Evidenced Based Answers at the Point of Care (an interactive case based session demonstrating the use of a number of evidence based resources, including UpToDate, to solve clinical questions during the course of patient care). Both courses are free of charge to current subscribers (institutional, no mention of individual).

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