Long-term clinical outcomes and economic evaluation of the ketogenic diet versus care as usual in children and adolescents with intractable epilepsy

Highlights • The KD group resulted in more responders and showed greater improvement on seizure severity. • The KD did not lead to a worsening of side-effects other than gastro-intestinal problems (at 4 months follow-up only). • The costs of the total follow-up were higher in the KD group compared to the control group. • As only a minimal difference was found between the KD and the CAU group regarding QALYs, inconclusive cost per QALY ratios resulted. • Compliance with the KD was shown to be difficult in some patients, resulting in a retention rate of 58% which is in line with previous literature.