{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T14:24:52Z","timestamp":1783088692267,"version":"3.54.6"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T00:00:00Z","timestamp":1317340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Interinstitutional consultation in pathology has shown to improve patient safety by detecting interpretive errors that may significantly impact clinical management. We conducted a study of 922 cases of thyroid FNAC slides, referred to our institution over a 2\u2010year period, to assess the magnitude of discrepancies and determine the clinical impact of second opinion. Disagreements were categorized as none, minor or major, the latter two defined as one\u2010 or two\u2010step deviations respectively on the NCI diagnostic categories scale. There were 122 disagreements (13%), including 44 major and 78 minor. Seventy\u2010five patients underwent a change in management based on second opinion, in conjunction with clinical and radiologic findings (age, size of nodule, family history, ultrasonographic appearance, and solitary versus multiple nodules). The second opinion was supported on follow\u2010up in 57% of major discrepancies, and the initial diagnosis was concurrent with the surgical diagnosis in 7% cases. The remainder (36%) of major discrepancy cases did not undergo surgery, precluding tissue confirmation. Critics have alleged increased costs due to interinstitutional consultations. However, cost avoidance from lost wages, potential surgical complications, and litigation is not easily quantified. Using a simplified calculation to objectively measure the costs associated with changed diagnoses, we estimate that second opinion of these 922 cases resulted in potential cost saving of $940,166 based on current Medicare reimbursement codes. Our study indicates the need for a quality\u2010control program of outside thyroid FNA slides, especially in \u201chigh discrepancy categories\u201d as discussed in the article. Diagn. Cytopathol. 2011;. \u00a9 2011 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/dc.21820","type":"journal-article","created":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T16:44:38Z","timestamp":1317401078000},"page":"422-429","source":"Crossref","is-referenced-by-count":24,"title":["Clinical impact of second opinion in thyroid fine needle aspiration cytology (FNAC): A study of 922 interinstitutional consultations"],"prefix":"10.1002","volume":"40","author":[{"given":"Jaya","family":"Bajaj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Morgenstern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sugrue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Wasserman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Wasserman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,9,30]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/114.3.329"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10105"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.moo.0000156162.20789.66"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2044"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10022"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000322365"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/00313020601032477"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200403000-00015"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCR.0b013e3181a05e5f"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199607000-00008"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)66249-0"},{"key":"e_1_2_6_13_2","first-page":"117","article-title":"Interinstitutional consultation in fine\u2010needle aspiration cytopathology","volume":"25","author":"Bomeisl PE","year":"2009","journal-title":"Cancer Cytopathol"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdc.21820","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.21820","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T19:58:48Z","timestamp":1700596728000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.21820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,9,30]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,5]]}},"alternative-id":["10.1002\/dc.21820"],"URL":"https:\/\/doi.org\/10.1002\/dc.21820","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,9,30]]}}}