Use of molecular testing results to analyze the overuse of atypia of undetermined significance in thyroid cytology

•Prompted by a higher than optimal institutional atypia of undetermined significance (AUS) rate, we examined using molecular testing results (MTR) as a potential quality metric tool to reduce the AUS rate.•We performed a retrospective study to analyze AUS molecular testing results, individual pathologist AUS usage rates, cytologic findings, and subsequent surgical outcomes.•Most AUS cases with molecular testing had negative MTR, and AUS with cytologic atypia had higher positive MTR risk.•Periodic analysis of MTR data and cytohistologic correlation, in conjunction with AUS rates for individual pathologists, may serve as a valuable quality improvement tool.