About
By a clinician-educator. For the people who teach the next generation of clinicians.
CertaintyGrade started with a frustration familiar to anyone who practices evidence-based medicine: evidence ratings are attached to papers, not to clinical questions — and that distinction matters more than most tools acknowledge.
The problem this tool solves
GRADE — the Grading of Recommendations Assessment, Development and Evaluation system — is the global standard for rating evidence certainty. But a critical nuance is routinely lost in practice: GRADE certainty applies to a specific answer for a specific question and outcome, not to a paper or a study design in the abstract.
A high-quality RCT may provide high certainty for a surrogate endpoint and very low certainty for the patient-oriented outcome you actually care about. A systematic review rated "high certainty" for mortality may tell you almost nothing about quality of life. The paper's label doesn't transfer automatically to your question.
CertaintyGrade enforces the right sequence: define your PICO question first, gather the relevant evidence, then apply GRADE domain by domain to that specific evidence body. The certainty level you receive is an answer to your question — not a badge borrowed from a paper.
About the creator
Adarsh K. Gupta, DO, MS, FACOFP
Family Physician · EBM Educator · Biomedical Engineer
Dr. Gupta is a board-certified family physician with graduate training in biomedical engineering and a long-standing focus on evidence-based medicine, clinical information literacy, and medical education.
He serves as an Associate Editor at Cochrane Clinical Answers — the consumer-facing summary layer of Cochrane systematic reviews — where he applies GRADE methodology to translate complex evidence into actionable clinical guidance, and is the author of 90+ peer-reviewed publications.
As Founding Director of the Center for Information Mastery at Rowan University School of Osteopathic Medicine (2009–2024), he built the institution's EBM and critical-appraisal curriculum from the ground up — the same curriculum-building work this tool is meant to extend. He also serves as National Faculty for NBOME, designing board-exam items and assessments to the same rigor expected here.
In 2015, he developed the Clinical Information Triage Tool — a 5-step EBM workflow that helps clinicians identify the right information source before they search, reducing wasted effort and improving retrieval accuracy.
Information Mastery & Clinical Information Triage
Information Mastery is a clinical decision-making framework developed by Drs. David Slawson and Allen Shaughnessy, built around a simple principle: prioritize POEMs (Patient-Oriented Evidence that Matters) over disease-oriented evidence that may not translate to patient benefit. Usefulness = Relevance × Validity / Work.
Dr. Gupta's Clinical Information Triage Tool adds a critical upstream step that is often overlooked: classifying the type of information need before searching. Not every clinical question belongs in PubMed.
The core insight
This triage-first approach saves time, reduces information overload, and routes clinicians to the most authoritative source for each information type. CertaintyGrade then picks up where the triage ends: once you know you have a specific clinical question, it applies rigorous GRADE methodology anchored to that exact question and outcome.
Open the Clinical Information Triage Tool →Ready to grade your evidence?
Start with your clinical question. GRADE the answer — not the paper.
Start Assessment →