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On the basis of the authors' personal experience, 12 recommendations with potential to improve clinical decision making, ensure quality, and reduce diagnostic error in thyroid FNAC and histopathology are presented. 1) use a standardized reporting terminology for thyroid FNAC; 2) understand and explain to service users the limitations of cytology and the standardized thyroid FNAC reporting terminology used; 3) the cytopathologist should review all relevant clinical and ultrasound findings, if feasible; 4) include the risk of malignancy in all FNAC reports if feasible; 5) collect data to calculate the local institutional risk of malignancy for FNAC if feasible; 6) accept that nondiagnostic FNAC will include small numbers of carcinomas; 7) use rapid on\u2010site evaluation and\/or educational sessions for aspirators if the nondiagnostic aspiration rate is high; 8) know the diagnostic pitfalls of both cytology and histopathology; 9) use special immunohistochemical and molecular techniques that are evidence\u2010based; 10) make use of second opinions, either in\u2010house or interinstitutional; 11) multidisciplinary discussion of cases before surgery or therapy is invaluable; and, finally, 12) manage patient and clinician expectations of thyroid cytology and histopathology. These 12 recommendations may assist in quality\u2010improvement initiatives and may reduce diagnostic errors in thyroid cytology and histopathology. Thyroid multidisciplinary case discussion remains the principal, overarching method for error reduction and for providing high\u2010quality clinical decision making.<\/jats:p>","DOI":"10.1002\/cncy.22309","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T08:54:46Z","timestamp":1592297686000},"page":"917-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Measures to reduce diagnostic error and improve clinical decision making in thyroid FNA aspiration cytology: A proposed framework"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1926-4631","authenticated-orcid":false,"given":"David N.","family":"Poller","sequence":"first","affiliation":[{"name":"Department of Pathology and Department of Cytology Queen Alexandra Hospital Portsmouth PO6 3LY United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Royal Victoria Infirmary Newcastle Upon Tyne United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9846-6682","authenticated-orcid":false,"given":"Massimo","family":"Bongiovanni","sequence":"additional","affiliation":[{"name":"SYNLAB Suisse SA Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Improving Diagnosis In Health Care. 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