Which grade from the USPSTF indicates that a service should not be provided?

In the grading system used by the U.S. Preventive Services Task Force (USPSTF), a grade of D indicates that a particular preventive service should not be routinely provided. This classification is based on evidence that the service is either ineffective or that the potential harms of the service outweigh the benefits. The recommendation essentially advises healthcare providers and patients that such services are not warranted and may even pose unnecessary risks.

In contrast, grades A and B signify that there is strong evidence supporting the effectiveness of a service, with grade A indicating high certainty of substantial benefits and grade B indicating high certainty of moderate benefits. Grade C, on the other hand, suggests that the service may be provided selectively based on individual circumstances, as the balance of benefits and harms is less clear.

Hence, a grade of D is unique in that it explicitly denotes the non-recommendation of the service, making it clear that it should not be pursued in routine clinical practice.