1. Define your question using PICO: Patient/Problem, Intervention, Comparison, and Outcome.
Patient/Problem: Children and young people under 19 years old who have nocturnal enuresis (bedwetting). Sub group to include patients with Special needs (learning disabilities, emotional and ADHD)
Intervention: Parent’s choice bed wetting Alarm alone (body worn, bed, vibrating, wireless, voice recorded, multi-tone, bell and pad)
Comparison: Choice compared to clinician’s choice: Treatment with medication desmopressin an ant diuretic hormone or arginine vasopressin
Outcome: Reduction/change in number of wet nights, Dry for 14 consecutive nights, Dry for 6 consecutive months (continuing success), Dry for 2 consecutive years, Adverse events, Psychological effects (self-esteem, self-concept, PinQ), Quality of life measure
2. Type your question: What is the clinical and cost effectiveness of alarms for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?
3. Type of clinical question: □ Therapy□Etiology□ Diagnosis□Prevention□ Prognosis□Others
3. List search terms and alternative terms/synonyms based on your PICO question. Include controlled vocabulary (subject headings) if possible.
Nocturnal enuresis
Bed wetting alarms
4. List any inclusion criteria that might pertain to your search.
Gender: ______________________________
Age Range: Below 19 years
Publication Dates: ______________________
Language: ____________________________
5. Type(s) of study/research design to include in your search.
□ Systematic Review
□ Randomized Controlled Trial (RCT)
□ Cohort Study
□ Case-control Study/Case Series
□ Qualitative Study
□ Economic Evaluation
□ Clinical Practice Guidelines
6. List the EBP resources you plan to search. (CINAHL, Medline, Cochrane, netting the evidence etc.).
Cochrane Database of Systematic Reviews (CDSR),
MEDLINE
CINAHL
PsycINFO
7. What information did you find to help answer your question?
1) Cochrane
Document: Douglas, C., 2003. Algorithmic Diagnosis of Symptoms and Signs. Lippincott Williams & Wilkins. Source: Cochrane Database of Systematic Reviews. 1, 2006
The tentative findings of this review suggest several possible benefits for bed wetting alarms, with the possibility of augmented reduction of bedwetting greater than 500 ml. This systematic review offer the relevant information that attest to the use of bed wetting a better means of controlling bed-wetting. This is important to this course in that it leads the practitioner to employ this strategy to fix the patients problem.
2) CINAHL:
Document :Springhouse. 2007 Nursing: Interpreting Signs and Symptoms. Lippincott Williams & Wilkins
Source:. CINAHL. 1, 2007
This source provides a randomized trial control on children who have undergone the bed wetting alarm system. The document states that Children randomized to the alarm approach had a better chance of a spontaneous reduction in bed-wetting than those randomized to the medication therapy. However, these effects are not conclusively generalizable. This document provides a ground on which to use the bed wetting alarm system as it is proven effective.
3) MEDLINE
Document: Douglas, C., 2007. Differential Diagnosis in Primary Care. Lippincott Williams & Wilkins.
Source: MEDLINE. 1, 2007.
In this research paper, one of six-care application papers published by Lamaze Inc. and reprinted with adequate authorization, the advantage of bedwetting alarms is conferred and offered as an proof-based application that assists to endorse, defend, and back its reduction. This provide the necessary clinical practice guidelines that helps out in providing the guideline in which to carry out the bed wetting alarm system.
4) PsycINFO
No relevant information
Search Strategy
The strategies were made available for utilization on the OVID interface and Search 2 by means of NLH. These databases were explored Cochrane Database of Systematic Reviews (CDSR), MEDLINE, CINAHL and PsycINFO . Searches were conducted for systematic reviews and randomized controlled trials using search filters developed by the Centre for Reviews and Dissemination, SIGN and Cochrane Collaboration. Copies of all the search strategies are available on request from the National Clinical Guidelines Centre.
1. Database; Cochrane
1 Nocturnal Enuresis/
2 (bedwett$ or (bed adj2 wett$)).ti,ab.
3 (enuresis adj nocturna).ti,ab.
4 (nocturna$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
5 (night$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
6 (sleep adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
7 (child$ adj enuresis).ti,ab.
8 or/1-7
9 Enuresis/
2. Database: CINAHL
1 Nocturnal Enuresis/
2 (bed wett$ or (bed adj2 wett$)).ti,ab.
3 enuresis nocturna.ti,ab.
4 (nocturna$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
5 (night$ adj2 (enuresis or enureetic$ or incontinence)).ti,ab.
6 (sleep adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
3. Database: Cinahl
1. (enuresis ADJ nocturna).ti,ab; .
2. (child* ADJ enuresis).ti,ab;
3. (nocturna adj2 enuresis).ti,ab;
4. (nocturna* adj2 enuresis).ti,ab; .
5.; (nocturna* adj2 enuretic*).ti,ab;
4. PsycINFO,
1. (bedwett*).ti,ab;
2. (bed adj2 wett*).ti,ab;
3. (enuresis ADJ nocturna).ti,ab;
4., (nocturna* adj2 enuresis).ti,ab;
5. (nocturna* adj2 enuret*).ti,ab;
Reference list
Douglas, C., 2003. Algorithmic Diagnosis of Symptoms and Signs. Lippincott Williams & Wilkins.Source: Cochrane Database of Systematic Reviews. 1, 2006.
Douglas, C., 2007. Differential Diagnosis in Primary Care. Lippincott Williams & Wilkins.
Source: Database of Abstracts of Reviews of Effects (DARE). 1, 2007.
Springhouse. 2007 Nursing: Interpreting Signs and Symptoms. Lippincott Williams & Wilkins
Source:. CINAHL. 1, 2007
