Evidence based curriculum design--use of a surgical database to identify non-perceived needs in educating otolaryngologists on pediatric conditions.

OBJECTIVE: To identify the common non-otolaryngological diagnoses (N-OD) encountered by a pediatric otolaryngologist in surgical patients. This information may help in educating otolaryngologists on relevant pediatric conditions among their patients.

DESIGN/SETTING: Cross-sectional, retrospective database review of entries from 2006 to 2008 at a tertiary pediatric centre involving the patient case load of a busy pediatric otolaryngologist.

MAIN OUTCOME MEASURES: The main outcome of this study was to identify the common (N-OD) encountered by a pediatric otolaryngologist. Conditions excluded from the analysis were surgical complications and diagnoses managed primarily by otolaryngologists (sleep disordered breathing and allergic rhinitis).

RESULTS: 1357 pediatric surgical entries were identified. Of these, 524 (38.6%) entries contained N-OD and underwent surgery. A total of 580 N-OD were identified for these 524 patients. The N-OD were identified and categorized into the following subheadings: syndromes/associations, respiratory and cardiac, gastrointestinal, developmental, metabolic, and miscellaneous conditions. The most common N-OD are gastro-esophageal reflux disease, obesity, history of prematurity, congenital heart disease, asthma developmental delay and Down syndrome. The commonest categories encountered were developmental (138), cardio-respiratory (114) and gastro-intestinal (114).

CONCLUSIONS: This paper identifies the common N-OD encountered by a pediatric otolaryngologist in children managed at a tertiary level. The highlighted N-OD may help as a guide on curriculum content for training residents and fellows and continued medical education.