False positive cases in thyroid cytopathology – the experience of a single laboratory and a systematic review

Cytopathology ◽  
2021 ◽  
Author(s):  
Tibor Mezei ◽  
Melinda Kolcsár ◽  
Ionela Pașcanu ◽  
Philippe Vielh
Keyword(s):  
Systematic Review ◽  
False Positive ◽  
Thyroid Cytopathology ◽  
Single Laboratory

Systematic Review: The Long-Term Effects of False-Positive Mammograms

2007 ◽  
Vol 146 (7) ◽  
pp. 502 ◽  
Author(s):  
Noel T. Brewer ◽  
Talya Salz ◽  
Sarah E. Lillie
Keyword(s):  
Systematic Review ◽  
False Positive ◽  
Long Term Effects

scholarly journals Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): our experience and a systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yanli Zhu ◽  
Yuntao Song ◽  
Guohui Xu ◽  
Zhihui Fan ◽  
Wenhao Ren
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Diagnostic Errors ◽  
Published Data ◽  
Cystic Lesions ◽  
Adenomatous Hyperplasia ◽  
Sensitivity Specificity

Abstract Objective FNA is a simple, safe, cost-effective and accurate diagnostic tool for the initial screening of patients with thyroid nodules. The aims of this study were to determine the diagnostic utility of FNAC performed in our institution, assess the cytomorphologic features that contribute to diagnostic errors and propose improvement measures. Methods A total of 2781 FNACs were included in the study, and 1122 cases were compared with their histological diagnoses. We retrospectively reexamined our discordant (both false-negative and false-positive) cases and performed a systematic review of previous studies on causes of misdiagnoses. Results When DC V and DC VI were both considered cytologic-positive, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 98.3, 30.9, 94.9, 58.3 and 93.5%, respectively. If DC VI was considered cytologic-positive, the sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC were 98.0, 84.0, 99.4, 58.3, and 97.5% respectively. The main cause of false-negative diagnoses was sampling error (13/15, 86.7%), while interpretation error led to the majority of the false-positive diagnoses (38/47, 80.9%). Overlapping cytological features in adenomatous hyperplasia, thyroiditis and cystic lesions were the major factors contributing to interpretation errors, while the size and number of nodules may have led to false-negative diagnoses because of heterogeneity and unsampled areas. Conclusions The sensitivity and PPV of thyroid FNAC in our institution were higher than those in the published data, while the specificity and NPV were lower. Regarding the FNA category DC V, a frozen section analysis during diagnostic lobectomy is necessary. Multiple passes should be performed in various parts of a large nodule or from different nodules to reduce the risk of false-negative findings. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis and cystic lesions to avoid false-positive diagnoses. NIFTP has little effect on diagnostic accuracy and the distribution of diagnostic errors.

scholarly journals Estimate of false-positive breast cancer diagnoses from accuracy studies: a systematic review

2017 ◽  
Vol 70 (4) ◽  
pp. 282-294 ◽  
Author(s):  
Nereo Segnan ◽  
Silvia Minozzi ◽  
Antonio Ponti ◽  
Cristina Bellisario ◽  
Sara Balduzzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
False Positive ◽  
Surgical Excision ◽  
Cochrane Library ◽  
Needle Core Biopsy ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
The Impact ◽  
Positive Breast Cancer

BackgroundFalse-positive histological diagnoses have the same consequences of overdiagnosis in terms of unnecessary treatment. The aim of this systematic review is to assess their frequency at needle core biopsy (CB) and/or surgical excision of the breast.MethodsPubMed, Embase, Cochrane Library were systematically searched up to 30 October 2015. Eligibility criteria: cross-sectional studies assessing diagnostic accuracy of CB compared with surgical excision; studies assessing reproducibility of pathologists reading the same slides. Outcomes: false-positive rates; Misclassification of Benign as Malignant (MBM) histological diagnosis; K statistic. Independent reviewers extracted data and assessed quality using an adapted QUADAS-2 tool.ResultsSixteen studies assessed CB false-positive rates. In 10 studies (41 989 screen-detected lesions), the range of false-positive rates was 0%–7.1%. Twenty-seven studies assessed pathologists' reproducibility. Studies with consecutive, random or stratified samples of all the specimens: at CB the MBM range was 0.25%–2.4% (K values 0.83–0.98); at surgical excision, it was 0.67%–1.2% (K values 0.86–0.94). Studies with enriched samples: the MBM range was 1.4%–6.2% (K values 0.57–0.86). Studies of cases selected for second opinion: the MBM range was 0.29%–12.2% (K values 0.48 and 0.50).ConclusionsHigh heterogeneity of the included studies precluded formal pooling estimates. When considering studies of higher sample size or methodological quality, false-positive rates and MBM are around 1%. The impact of false-positive histological diagnoses of breast cancer on unnecessary treatment, as well as that of overdiagnosis, is not negligible and is of importance in clinical practice.

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