To the Editor We read with great interest the recently published article by Dublin et al in JAMA Otolaryngology–Head & Neck Surgery, where it was shown that for indeterminate nodules larger than 4 cm, the positive-predictive value of a genomic classifier test (ThyroSeq) was 50% and the negative predictive value (NPV) was 89%. These values were noted to be improved relative to the test's performance on smaller nodules. The authors point out that the 2015 American Thyroid Association guidelines suggest that total thyroidectomy may be preferred for indeterminate nodules that are large (>4 cm) to limit completion thyroidectomy and conclude from their analysis that thyroid lobectomy may be sufficient for genomic classifier-negative indeterminate nodules.
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