Abstract
We (a pathologist and an endocrinologist) share the concern of Lewis et al. (1) about the variability of reports from thyroidal aspirates. We agree that there is a need for uniformity in statistical reporting for accurate understanding of the clinical utility of thyroidal fine-needle aspirations. It is a common complaint from referring physicians that some fine-needle aspiration reports are so vague that they are considered meaningless or perhaps even misleading. We should strive for uniform classification and nomenclature. The six-tier reporting system proposed by the National Cancer Institute is a good starting point (2), and this system needs to be evaluated further in a detailed manner. Adoption of an electronic patient record would assist in the development and implementation of a uniform system of encoding data. Cytopathologists have to standardize and simplify reports so that they will be more meaningful to the clinicians and more relevant to the patients (3 –5). We should realize the profound impact the terminology used has on classification of disease, therapy, and outcome. Terminology should be reliable, reproducible, valid, uniform, and simple. It is imperative that the clinician comprehends the precise meaning of the cytopathologist's interpretation, and editors should insist that the articles adhere to the proposed system. We should strive for consensus in consistent terminology. Let us emphasize that consensus does not imply unanimous consent but rather “the acquiescence of those who care [about the particular decision], supported by the apathy of those who don't.” (Harlan Cleveland).