{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:12:48Z","timestamp":1787314368233,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Recently, the Qu\u00e9bec public health care system established a pilot project to cover costs of molecular testing for select patients with cytologically-indeterminate thyroid nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the clinical utility of the ThyroSeqv3 molecular test pilot project at McGill University in surgical management of thyroid nodules within Canada\u2019s single-payer health care system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicenter cohort study, in liaison with the Qu\u00e9bec Health Ministry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Jewish General Hospital and Royal Victoria Hospital in Montreal, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with a Bethesda III or IV and TIRADS 3 or 4 thyroid nodule measuring between 1 and 4\u2009cm in size on ultrasound were analyzed across pre- and post-pilot project phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>The pre-pilot project surgical control group included patients who underwent surgical intervention, excluding those who opted for out-of-pocket molecular testing. The post-pilot project surgical exposure group encompassed participants in the pilot project, undergoing publicly-funded ThyroSeqv3 molecular testing and subsequent surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Surgical malignancy\/noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 314 patients qualified for the pilot project, with 207 (65.9%) having Bethesda III nodules and 107 (34.1%) having Bethesda IV nodules. Molecular testing yielded a result of negative in 238 (75.8%) cases and positive in 76 (24.2%) cases. Histopathology reports of positive patients who opted for surgery revealed a surgical malignancy\/NIFTP rate of 73.1%. The surgical malignancy\/NIFTP rate at our institution prior to the implementation of the pilot project for patients adhering to the inclusion criteria was statistically significantly lower at 47.9% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ThyroSeqv3 molecular test pilot project has improved upon physicians\u2019 traditional clinical practice by enabling a wider patient population to access this otherwise costly technology. It not only curtailed futile diagnostic hemithyroidectomies but also led to a more discerning allocation of surgeries, as corroborated by an increased surgical malignancy\/NIFTP rate post-implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>The results of our study suggest that publicly-funded molecular testing could contribute positively to the Canadian single-payer health care system by optimizing patient outcomes as well as fiscal policy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251336687","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:03:17Z","timestamp":1748401397000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Role of Publicly-Funded Molecular Testing in Surgical Management of Thyroid Nodules within Canadian Medicare: Clinical Assessment of ThyroSeqv3 Molecular Test Pilot Project at McGill University"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3763-2119","authenticated-orcid":false,"given":"Saruchi","family":"Bandargal","sequence":"first","affiliation":[{"name":"Faculty of Medicine, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Hier","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mawaddah","family":"Abdulhaleem","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Royal Victoria Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique-Isabelle","family":"Forest","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Royal Victoria Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryse","family":"Brassard","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Universit\u00e9 Laval, Centre Hospitalier Universitaire de Qu\u00e9bec, Quebec City, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevi\u00e8ve","family":"Rondeau","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Universit\u00e9 de Montr\u00e9al, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9641-5866","authenticated-orcid":false,"given":"Orr","family":"Dimitstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Royal Victoria Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Mascarella","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Royal Victoria Hospital, McGill University, Montreal, QC, 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Philippe","family":"Pusztaszeri","sequence":"additional","affiliation":[{"name":"Department of Pathology, Jewish General Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Fortier","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Universit\u00e9 de Sherbrooke, Sherbrooke, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Beaudoin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Universit\u00e9 Laval, Centre Hospitalier Universitaire de Qu\u00e9bec, Quebec City, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Helene","family":"Massicotte","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Universit\u00e9 de Montr\u00e9al, Centre Hospitalier de l\u2019Universit\u00e9 de 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