American Association of Clinical Endocrinologists, American College of Endocrinology Announce Publication of First Disease State Commentary, Special Thyroid Section

JACKSONVILLE, Fla. – (April 24, 2014) – The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have issued a trio of thyroid-related manuscripts, including the first AACE/ACE Disease State Commentary, a new category of white paper for the organizations. All of the manuscripts are published as a special section in the Volume 20, Number 4, April 2014 issue of Endocrine Practice, AACE’s official peer-review journal.

The commentary, entitled “Molecular Diagnostic Testing of Thyroid Nodules with Indeterminate Cytopathology,” examines two so-called “molecular marker” tests utilized as an adjunct to fine-needle aspiration (FNA) biopsies in assessing the malignancy risk of thyroid nodules that have been classified as “indeterminate” via FNA, with the goal of providing physicians with a practical assessment of the tests’ value as a diagnostic tool. While the molecular marker tests are a valued addition to a clinician’s arsenal, the commentary suggests these tests are a complement to, rather than a replacement for, a clinical judgment process that should weigh patient characteristics, physical examination findings, thyroid ultrasound features and FNA biopsy cytologic details.

A second manuscript published in the journal special section, “Surgical Utility of Afirma: Effects of High Cancer Prevalence and Oncocyctic Cell Types in Patients with Indeterminate Thyroid Cytology,” reports specifically on the performance of one of the two most prominent molecular marker tests, assessed over a 27-month period in 519 patients of a south Florida endocrine surgery practice whose patients’ nodules were biopsied in compliance with AACE/ACE Thyroid Nodule Guidelines

“Molecular markers offer great promise in the thyroid cancer arena, but clinicians still need guidance in how to use these potentially powerful and expensive tools,” said Dr. R. Mack Harrell, MD, FACP, FACE, ECNU, co-author of the molecular marker article and AACE President Elect. “Our paper demonstrates potential pitfalls in the use of the Afirma test in surgical decision-making and serves to highlight the importance of endocrinologic and endocrine surgical judgment in carefully weighing all patient characteristics before taking a patient to the operating room. At present, no molecular test can replace the judgment of a clinical endocrinologist.”

The special section also highlights the development of a computer-interpretable algorithm for the purpose of U.S. and European clinicians who evaluate and manage patients with thyroid nodules with the article, “A Computer-Interpretable Clinical Guideline for the Diagnosis and Management of Thyroid Nodules.” The algorithm is based on the narrative clinical practice guideline (CPG) issued jointly in 2010 by AACE, the European Thyroid Association and the Associazione Medici Endocrinologi.

“This novel interactive, web-based electronic guideline is designed to guide non-expert clinicians in the management of thyroid nodules,” said Dr. Jeffrey R. Garber, MD, FACP, FACE, Chair of the AACE Thyroid Scientific Committee. “Its significance goes far beyond this by establishing a prototype for creating readily accessible electronic tools that can be used to evaluate many other disorders.”


About the Journal Endocrine Practice, the official journal of the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE), is a peer-reviewed journal published twelve times a year. The Journal publishes the latest information in the treatment of diabetes, thyroid disease, obesity, growth hormone deficiency, sexual dysfunction and osteoporosis, and contains original articles, case reports, review articles, commentaries, editorials, visual vignettes, as well as classified and display advertising. Special issues of Endocrine Practice also include AACE clinical practice guidelines and other AACE/ACE white papers. Complete content is available on the Endocrine Practice Web site at

About the American Association of Clinical Endocrinologists (AACE)

The American Association of Clinical Endocrinologists (AACE) represents more than 6,500 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. The majority of AACE members are certified in endocrinology, diabetes and metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at

About the American College of Endocrinology (ACE) The American College of Endocrinology (ACE) is the educational and scientific arm of the American Association of Clinical Endocrinologists (AACE). ACE is the leader in advancing the care and prevention of endocrine and metabolic disorders by: providing professional education and reliable public health information; recognizing excellence in education, research and service; promoting clinical research and defining the future of Clinical Endocrinology. For more information, please visit