Context

The decision of whether to recommend workup of thyroid nodules is a difficult one. Conflicting guidelines result in highly variable practices.1 ,2 Some argue that thyroid fine-needle aspiration (FNA) carries minimal risk and provides definitive pathology results; however, benign thyroid nodules are common and an increasing number of thyroid biopsies in the USA result in a costly problem for the healthcare system.3 Furthermore, for one-third of patients’ workup does not end with FNA; cytology results can lead to repeat biopsies and even diagnostic lobectomy.4 Finally, there is an alarming rise in …