There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. There is high certainty that the net benefit is substantial. Determining whether or not the service should be offered or provided to an individual patient will typically require an informed conversation between the clinician and patient. Grade C recommendations are particularly sensitive to patient values and circumstances. Given this small net benefit, the USPSTF has either not made a recommendation “for or against routinely” providing the service (1998), recommended “against routinely” providing the service (2007), or recommended “selectively” providing the service (2012). Despite these revisions, the essence of the C recommendation has remained consistent: at the population level, the balance of benefits and harms is very close, and the magnitude of net benefit is small. Although most of the grade definitions have evolved since the USPSTF first began, none has changed more noticeably than the definition of a C recommendation, which has undergone three major revisions since 1998. Describing the strength of a recommendation is an important part of communicating its importance to clinicians and other users. This new definition applies to USPSTF recommendations voted on after July 2012. The USPSTF updated its definition of and suggestions for practice for the grade C recommendation. Grade Definitions After July 2012 What the Grades Mean and Suggestions for Practice The USPSTF changed its grade definitions based on a change in methods in May 2007 and again in July 2012, when it updated the definition of and suggestions for practice for the grade C recommendation. Preventive Services Task Force (USPSTF) assigns one of five letter grades (A, B, C, D, or I).
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