Identifying Targets for Innovation in Amazon Reviews of Bedwetting Alarms: Thematic Analysis (Preprint)

Abstract

BACKGROUND Nocturnal enuresis (NE) is a frequent diagnosis in the pediatric and adolescent populations with an estimated prevalence of around 15% at age 6 years. NE can have a significant impact on multiple domains of health. Bedwetting alarms, which typically consist of a sensor and moisture-activated alarm, are a common treatment. The OBJECTIVE The aim of this study was to determine areas of satisfaction versus dissatisfaction reported by the parents/caregivers of users of current bedwetting alarms. METHODS Using the search term “bedwetting alarms” on Amazon marketplace, products with >300 reviews were included. For each product, the 5 most helpful reviews for each star category were collected for analysis. Meaning extraction method, a natural language processing technique, was applied to identify major themes and subcategories. A percent skew was calculated by summating the total number of mentions of each subtheme: +1 for a positive, 0 for neutral, and -1 for a negative mention and dividing this total by the number of reviews in which that subtheme was observed. Sub-analyses were performed for age and sex. RESULTS Of 136 products identified, 10 were evaluated based on selection criteria. Main themes identified across products were long-term concerns, marketing, alarm system, and device mechanics and features. Subthemes identified as future targets for innovation included alarm accuracy, alarm volume variability, device durability, user friendliness, and adaptability to female children. In general, durability, alarm accuracy, and comfort were the most negatively skewed subthemes indicative of potential areas for improvement, and effectiveness was the only significantly positively skewed subtheme. Alarm sound and device features were positively skewed for older children, while ease of use had a negative skew for younger children. Girls and their caretakers reported negative experiences with devices that featured cords, arm bands, and sensor pads. CONCLUSIONS This analysis provides an innovation roadmap for future device design to improve satisfaction and compliance with bedwetting alarms. Our results highlight the need for additional options in alarm sound features, as children of different ages have divergent preferences in this domain. Additionally, young girls and their parents/caretakers provided more negative reviews overall regarding the range of current device features compared to boys, indicating devices are not adequately developed to meet patient needs regardless of sex. Put together, this review highlights multiple device features that are targets for innovation to ensure translational efficacy regardless of age, sex, or specific family needs.