To appraise clinical practice guidelines for anaplastic thyroid carcinoma treatment and management using the Appraisal of Guidelines for Research and Evaluation II tool.

A literature search was performed using MEDLINE/PubMed, Embase, Scopus, Cochrane, and Google Scholar. Four reviewers evaluated clinical practice guidelines utilising Appraisal of Guidelines for Research and Evaluation II, with domain scores requiring a threshold of greater than 60 per cent. Inter-reviewer agreement was evaluated using intraclass correlation coefficients.

Twelve clinical practice guidelines were evaluated after application of inclusion and exclusion criteria. There were two “high-”, four “average-”, and six “low-” quality clinical practice guidelines. The domains with the highest scores were “clarity of presentation” (69.44 ± 16.75) and “scope and purpose” (68.87 ± 20.88), while “applicability” (7.12 ± 6.17) and “rigor of development” (50.26 ± 20.77) had the lowest scores. Intraclass correlation coefficients showed a high level of inter-reviewer agreement (0.689–0.924; good–excellent).

These results showcased wide variability in quality amongst guidelines for the treatment and management of anaplastic thyroid carcinoma. These findings necessitate greater standardisation among clinical practice guidelines and greater focus on the applicability of recommended practices.

Dental and mucosal injuries from laryngoscopy in the peri-operative period are common medico-legal complaints. This study investigated lawsuits arising from laryngoscopy.

Westlaw, a legal database containing trial records from across the USA, was retrospectively reviewed. Plaintiff and/or defendant characteristics, claimed injuries, legal outcomes and awards were extracted.

Of all laryngoscopy-related dental or mucosal injuries brought before a state or federal court, none (0 per cent) resulted in a defence verdict against the provider or monetary gain for the patient. Rulings in the patient's favour were observed only when laryngoscopy was found to be the proximate cause of multiple compounding complications that culminated in severe medical outcomes such as exsanguination, septic shock or cardiopulmonary arrest.

Proper laryngoscopy technique and a robust informed-consent process that accurately sets patients' expectations reduces litigation risk. Future litigation pursuits should consider the low likelihood of malpractice allegation success at trial.

The fragility index represents the minimum number of patients required to convert an outcome from statistically significant to insignificant. This report assesses the fragility index of head and neck cancer randomised, controlled trials.

Studies were extracted from PubMed/Medline, Scopus, Embase and Cochrane databases.

Overall, 123 randomised, controlled trials were included. The sample size and fragility index medians (interquartile ranges) were 103 (56–213) and 2 (0–5), respectively. The fragility index exceeded the number of patients lost to follow up in 42.3 per cent (n = 52) of studies. A higher fragility index correlated with higher sample size (r = 0.514, p < 0.001), number of events (r = 0.449, p < 0.001) and statistical significance via p-value (r = −0.367, p < 0.001).

Head and neck cancer randomised, controlled trials demonstrated low fragility index values, in which statistically significant results could be nullified by altering the outcomes of just two patients, on average. Future head and neck oncology randomised, controlled trials should report the fragility index in order to provide insight into statistical robustness.