Cochrane · systematic review · CD002911
Alarm interventions for nocturnal enuresis in children
Caldwell, PHY, Codarini, M, Stewart, F, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
IncontinenceAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
55
current version
GRADE rated
47
No studies
4
Included studies
NR
No studies 4 · 7.3%Ungraded 4 · 7.3%Very low 28 · 50.9%Low 14 · 25.5%Moderate 5 · 9.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Alarm compared to control or no treatment for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week Alarm vs control or no treatment | no estimate extracted | 4 studies · 127 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment Alarm vs control or no treatment | RR 7.23 [1.4, 37.33] | 18 studies · 827 participants | Low Downgraded: risk of bias, publication bias |
Proportion of children dry at Alarm vs control or no treatment | RR 9.67 [4.74, 19.76] | 10 studies · 366 participants | Low Downgraded: imprecision |
Proportion of children with adverse events Alarm vs control or no treatment | no estimate extracted | NR | No studies |
Alarm compared to placebo drug for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week Alarm vs placebo drug | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment Alarm vs placebo drug | RR 1.59 [1.16, 2.17] | 2 studies · 181 participants | Low Downgraded: imprecision |
Proportion of children dry at Alarm vs placebo drug | no estimate extracted | NR | No studies |
Proportion of children with adverse events Alarm vs placebo drug | no estimate extracted | 2 studies · 2 participants | Ungraded |
Alarm compared to other types of alarm for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ bell and pad versus body‐worn alarm Alarm vs other types of alarm | RR 1 [0.67, 1.5] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs other types of alarm | RR 0.91 [0.5, 1.64] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ standard alarm versus intermittent alarm Alarm vs other types of alarm | RR 1.06 [0.82, 1.36] | 3 studies · 86 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportion of children dry at Alarm vs other types of alarm | RR 0.7 [0.37, 1.35] | 2 studies · 59 participants | Very low Downgraded: risk of bias, imprecision |
Mean number of wet nights a week ‐ immediate alarm versus delayed alarm Alarm vs other types of alarm | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ immediate alarm versus delayed alarm Alarm vs other types of alarm | RR 1.88 [0.97, 3.63] | 2 studies · 62 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs other types of alarm | RR 3 [0.74, 12.21] | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision |
Mean number of wet nights per week ‐ alarm versus twin signal Alarm vs other types of alarm | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm versus twin‐signal alarm Alarm vs other types of alarm | RR 0.94 [0.79, 1.13] | 3 studies · 78 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportion of children dry at Alarm vs other types of alarm | RR 0.93 [0.56, 1.53] | 2 studies · 48 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ bell and pad versus electric shock alarms Alarm vs other types of alarm | RR 1 [0.79, 1.27] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs other types of alarm | RR 1.17 [0.56, 2.45] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children with adverse events ‐ bell and pad alarm vs electric shock alarm Alarm vs other types of alarm | no estimate extracted | 1 study · 36 participants | Ungraded |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ loud versus quiet alarms Alarm vs other types of alarm | RR 1.33 [0.89, 1.99] | 2 studies · 40 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs other types of alarm | RR 0.9 [0.47, 1.71] | 2 studies · 40 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ audio vs vibrating alarms Alarm vs other types of alarm | RR 0.68 [0.45, 1.01] | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ code‐word alarm versus control alarm Alarm vs other types of alarm | RR 1.11 [0.97, 1.27] | 1 study · 353 participants | Moderate Downgraded: imprecision |
Proportion of children dry at Alarm vs other types of alarm | RR 0.91 [0.79, 1.05] | 1 study · 353 participants | Moderate Downgraded: imprecision |
Proportion of children with adverse events ‐ code‐word alarm versus control alarm Alarm vs other types of alarm | RR 1.34 [0.75, 2.38] | 1 study · 353 participants | Moderate Downgraded: imprecision |
Alarm compared to other behavioural interventions for nocturnal enuresis in children
Population: children with nocturnal enuresis in children
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week Alarm vs other behavioural interventions | no estimate extracted | 3 studies · 95 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment Alarm vs other behavioural interventions | RR 1.77 [0.98, 3.19] | 6 studies · 179 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs other behavioural interventions | RR 1.39 [0.81, 2.41] | 3 studies · 89 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children with adverse events Alarm vs other behavioural interventions | no estimate extracted | NR | No studies |
Alarm compared to desmopressin for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week Alarm vs desmopressin | no estimate extracted | 4 studies · 285 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment Alarm vs desmopressin | RR 1.12 [0.93, 1.36] | 12 studies · 1168 participants | Low Downgraded: risk of bias, publication bias |
Proportion of children dry at Alarm vs desmopressin | RR 1.3 [0.92, 1.84] | 5 studies · 565 participants | Moderate Downgraded: risk of bias |
Proportion of children with adverse events Alarm vs desmopressin | RR 0.38 [0.2, 0.71] | 5 studies · 565 participants | Moderate Downgraded: risk of bias |
Alarm compared to tricyclics for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week Alarm vs tricyclics | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment Alarm vs tricyclics | RR 2.05 [1.33, 3.17] | 3 studies · 208 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs tricyclics | RR 11 [0.67, 179.29] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children with adverse events Alarm vs tricyclics | no estimate extracted | 1 study · 1 participants | Ungraded |
Alarm compared to miscellaneous treatments for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week ‐ alarm versus cognitive behavioural therapy Alarm vs miscellaneous treatments | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm versus cognitive behavioural therapy Alarm vs miscellaneous treatments | RR 0.84 [0.55, 1.29] | 1 study · 39 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs miscellaneous treatments | RR 0.48 [0.25, 0.92] | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm versus psychotherapy Alarm vs miscellaneous treatments | RR 3.62 [1.38, 9.5] | 2 studies · 116 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm versus hypnotherapy Alarm vs miscellaneous treatments | RR 3 [1.41, 6.39] | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm vs miscellaneous treatments | RR 3 [1.18, 7.6] | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm versus restricted diet Alarm vs miscellaneous treatments | RR 23 [3.19, 165.98] | 1 study · 150 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children adverse events Alarm vs miscellaneous treatments | no estimate extracted | NR | No studies |
Alarm plus other intervention versus other intervention for nocturnal enuresis in children
Population: children with nocturnal enuresis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean number of wet nights a week ‐ alarm + bladder training versus bladder training Alarm plus other intervention vs other intervention | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm + bladder training versus bladder training Alarm plus other intervention vs other intervention | RR 3 [0.73, 12.27] | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm + dry‐bed training versus dry‐bed training Alarm plus other intervention vs other intervention | RR 3.79 [1.85, 7.77] | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm plus other intervention vs other intervention | RR 0.56 [0.15, 2.12] | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision |
Mean number of wet nights a week ‐ alarm + desmopressin versus desmopressin Alarm plus other intervention vs other intervention | no estimate extracted | 2 studies · 156 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children achieving 14 consecutive dry nights by the end of treatment ‐ alarm + desmopressin versus desmopressin Alarm plus other intervention vs other intervention | RR 1.32 [1.08, 1.62] | 5 studies · 359 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children dry at Alarm plus other intervention vs other intervention | RR 2.33 [1.26, 4.29] | 2 studies · 161 participants | Low Downgraded: risk of bias, imprecision |
Proportion of children with adverse events Alarm plus other intervention vs other intervention | no estimate extracted | 1 study · 1 participants | Ungraded |