{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:19:12Z","timestamp":1783448352019,"version":"3.55.0"},"reference-count":19,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":196,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Thyroid nodules are common, affecting approximately 50% of individuals. These nodules are often discovered incidentally and exhibit benign characteristics. Following a suspicious ultrasound, a fine-needle aspiration biopsy (FNAB) is performed to assess the risk of malignancy. However, approximately 30% of cases are classified as indeterminate by cytology. In response, the development of molecular tests has refined malignancy risk assessment and reduced the need for diagnostic surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To independently evaluate the real-world clinical utility and the diagnostic performance of a microRNA-based molecular test (mir-THYpe full) in improving diagnostic accuracy and avoiding unnecessary surgeries in indeterminate thyroid nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is the first external, independent, prospective, real-world, observational, and non-interventional validation study of this molecular classifier. A total of 256 patients with nodules classified as Bethesda III\/IV were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The test was positive for malignancy in 90 patients, 79 (90%) of whom underwent surgery. Of the 158 test-negative nodules, 7 (4.4%) underwent thyroidectomy. The test demonstrated a sensitivity of 83.0%, a specificity of 83.5%, a positive predictive value of 62.8%, and a negative predictive value of 93.6%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The mir-THYpe full molecular test supported 95.5% of clinical decisions when negative and 89.8% when positive, reducing surgery rates by 79.5%. Therefore, the integration of this microRNA-based classifier into clinical practice represents a valuable tool in managing indeterminate thyroid nodules, reducing unnecessary thyroidectomies, and conserving valuable healthcare resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-25-0105","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T12:54:25Z","timestamp":1765198465000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":1,"title":["External validation of a microRNA thyroid classifier: a real-world prospective study"],"prefix":"10.1530","volume":"14","author":[{"given":"Eduarda","family":"Gregorio Arnaut Lima","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kely","family":"Silveira 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