UpToDate Editorial Process

Our rigorous editorial process is a key reason why UpToDate is the world’s most trusted clinical decision support reference. Our process isn’t just a goal or theoretical plan; it’s a commitment that is consistently followed — without compromise.

Every day, our team of clinician authors, editors, and peer reviewers collaborate to produce evidence-based content and recommendations in a succinct, searchable format that can be quickly and easily accessed at the point of care.

Each topic has an expert physician author and at least two physician reviewers in the specialty. This group performs a comprehensive review of the literature and agree on clear recommendations for treatment and screening in order to help clinicians make the best care decisions possible.

Transparency, rigor, and independence are at the heart of our editorial process

Authors and editors are clearly identified at the top of every clinical topic, along with the publication and literature review dates and detailed references with links. The contributors’ affiliations and peer reviewers’ information is also available.

We are systematic in how we identify, review and synthesize clinical evidence as it applies to a clinical question. At the top of the evidence hierarchy are meta-analyses and randomized trials of high methodological quality, followed by randomized trials with methodological limitations, then observational studies and unsystematic clinical observations. Inferences are stronger when the evidence is summarized in systematic reviews that present all relevant data. Our in-house physician deputy editors, all of whom receive training in clinical epidemiology, oversee the integrity and consistency of this process, working closely with the authors.

For off-label drug use (that is, uses that are not approved by the U.S. Food and Drug Administration), clinicians are advised to check in a selection of drug monographs from our reference, Lexicomp®. Our physician and pharmacy editors and experts work together to align drug content with clinical insights and to select monographs for publication in UpToDate.¹

The clinician is advised to check UpToDate’s drug information database to verify conditions of use and to identify any changes in drug dosage, schedule or contraindications. Some topics contain discussions of “off-label” drug uses.

Our conflict of interest policy is designed to ensure that our content remains impartial and unbiased, and we never offer advertising or sponsorship in UpToDate.