title: Implementation of the Bethesda System for Reporting Thyroid Cytopathology: observations from the 2011 thyroid supplemental questionnaire of the College of American Pathologists.
abstract: BACKGROUND
  Although information about the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely disseminated since its inception in 2007, the extent of its implementation and impact on daily practice has not been formally evaluated.
  
  
  OBJECTIVE
  To assess the extent of uptake of TBSRTC across pathology laboratories and to evaluate its impact on daily practice by collating participant responses to the 2011 supplemental thyroid questionnaire of the College of American Pathologists.
  
  
  METHODS
  A questionnaire was designed to gather information about various aspects of TBSRTC and mailed in June 2011 to 2063 laboratories participating in the College of American Pathologists cytopathology interlaboratory comparison program. The participating laboratories' answers were collated and summarized.
  
  
  RESULTS
  Seven hundred and seventy-seven laboratories (37.6%) returned the survey. Although 60.9% (n = 451) and 17.1% (n = 127) of laboratories reported using TBSRTC or planning to use it in the near future, respectively, 22% (n = 163) had no plans to implement TBSRTC. Of the latter, 32% (n = 70) stated that they were unaware of this classification system. The majority (78.3%, n = 343) of the laboratories used TBSRTC as published in the Thyroid Bethesda System atlas, whereas 21.7% (n = 95) used it with minor modifications. Most reported that the use of TBSRTC had caused either no change (n = 67, 15.2%) or only minor changes (n = 353, 80.2%) in the terminology and diagnostic criteria previously used in their laboratories.
  
  
  CONCLUSIONS
  According to the collected data, TBSRTC is generally well implemented in pathology laboratories. However, because approximately a third of those not using this terminology are not aware of it, additional educational efforts regarding TBSRTC are warranted.
authors.affiliation: From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger);
authors.forename: Manon
authors.initials: M
authors.lastname: Auger
authors.forename: Ritu
authors.initials: R
authors.lastname: Nayar
authors.forename: Walid E
authors.initials: WE
authors.lastname: Khalbuss
authors.forename: Güliz A
authors.initials: GA
authors.lastname: Barkan
authors.forename: Cynthia C
authors.initials: CC
authors.lastname: Benedict
authors.forename: Rosemary
authors.initials: R
authors.lastname: Tambouret
authors.forename: Mary R
authors.initials: MR
authors.lastname: Schwartz
authors.forename: Lydia P
authors.initials: LP
authors.lastname: Howell
authors.forename: Rhona J
authors.initials: RJ
authors.lastname: Souers
authors.forename: David A
authors.initials: DA
authors.lastname: Hartley
authors.forename: Nicole
authors.initials: N
authors.lastname: Thomas
authors.forename: Ann T
authors.initials: AT
authors.lastname: Moriarty
mesh_terms: D001707:Biopsy, Needle / Q000379:methods; D019411:Clinical Laboratory Techniques / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D007753:Laboratories / Q000592:standards; D008396:Maryland; D015588:Observer Variation; D010338:Pathology, Clinical / Q000592:standards; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D013959:Thyroid Diseases / Q000175:diagnosis / Q000473:pathology; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology; D014481:United States