What does a grade C imply about individualization and practice?

• A. Strong endorsement for universal screening
• B. High harm
• C. No evidence
• D. Individualization; preference-based decisions with risk

Answer: (D)

The idea here is that a grade like this flags a small overall net benefit, so the best approach is to tailor the decision to each patient. It means you don’t screen everyone by default; instead, you discuss the potential benefits, harms, and uncertainties with the patient and make a shared decision based on that individual’s risk factors, values, and preferences. If the patient agrees that the potential benefit justifies the risks and costs, you offer the service; if not, you don’t. This is about individualization and preference-driven choices rather than a universal rule. It’s not about no evidence or about high harm—the emphasis is on weighing modest benefit and tailoring the approach to the person in front of you.