PC3011: Identifying Targets for Innovation: A Thematic Analysis of Bedwetting Alarm Reviews

Purpose/Objectives: Nocturnal enuresis (NE) is prevalent in young children and teens, and can have a significant impact on physical, emotional, and mental health (Bhaktiar 2014). Bedwetting alarms are a common treatment, typically consisting of a sensor and moisture activated alarm. As a part of a summer medical school innovation-based program at UCLA (SLING Health), the top unmet clinical need identified in pediatric urology was the desire by families and children for bedwetting management devices that decrease time to resolution, maximize device compliance, and prevent incontinence during treatment. The aim of this study was to further determine the specific areas of satisfaction versus dissatisfaction reported in recent online reviews by users of current bedwetting alarms.

Design/Methods: Reviews and devices were selected for evaluation using the current Amazon rating system. Using the search term “bedwetting alarms” on Amazon marketplace, products with >300 reviews were included. Amazon users rate products via a 5-star rating system, with 1 star being the lowest rating and 5 being the highest. For each product, the most upvoted 5 reviews for each star category were collected for analysis, resulting in 25 reviews per product. Meaning extraction method, a natural language processing technique, was applied to identify major themes and subcategories (Denecke 2014). Two researchers were assigned to each product, with a total of four reviewers (bioengineering and medical students in discussion with a pediatric urologist faculty member) evaluating reviews. Preliminary themes and subthemes were established among all 4 reviewers, with concordance created via discussion following independent reviews. Summation of thematic references in the 25 reviews of each product were tabulated.

Results: Of 215 bedwetting alarms identified between 2/9/22 – 3/28/22, 10 products were included for analysis. The main themes identified across products were long-term concerns, marketing, alarm system, and device mechanics and features (Table I). Products ranged from $33.99 to $299.99, with each device having varied specific features. Examples included a sensor pad versus a clip sensor, location of alarm, or inclusion of reinforcement programs. Reinforcement programs had a substantial effect on effectiveness by increasing motivation of children via a reward system. Subthemes identified as specific future targets for innovation included alarm accuracy, alarm volume variability, durability, user friendliness, and adaptability to both genders (Table II).

Conclusion/Discussion: This study validated our qualitative findings in the clinical setting regarding an unmet need for innovation in bedwetting alarm systems. To improve satisfaction and compliance with bedwetting alarms, our study provides a roadmap of development for subsequent devices. Future prototype evaluation should prioritize identified device features to optimize translatability.