Mapping of the QOLIE-31P to EQ-5D-5L utilities and 61 comparison of the responsiveness of both instruments in epilepsy Chapter 5:Using best-worst scaling to investigate preferences in health care: 77 A systematic review Part II Economic evaluations within epilepsyChapter 6: How to prepare a systematic review of economic evaluations 105 for informing evidence-based healthcare decisions: data extraction, risk of bias, and transferability (Part 3 of 3)Chapter 7:A systematic review of economic evaluations of treatments for 125 patients with epilepsy Chapter 8:Long-term clinical outcomes and economic evaluation of the 161 ketogenic diet versus care as usual among children and adolescents with intractable epilepsy Chapter 9:(Cost)-effectiveness of a multi-component intervention for 181 adults with epilepsy: study protocol of a Dutch randomized controlled trial (ZMILE study). In current practice, there is still a considerable need for improvement of the diagnosis, classification, treatment and management of epilepsy. For example, diagnosing epilepsy is a lengthy process that can be a burden for the patient and weighs (financially) heavily on the health system (health insurance), while misdiagnoses are quite common. As seizures are infrequent events in the majority of patients, recording of ictal (e.g. during seizures) EEG is both time-consuming and expensive. The mainstay of diagnosis, therefore, remains the detection of interictal epileptiform discharges (IEDs). 13IEDs in the electroencephalograph are used to confirm the clinical diagnosis of epilepsy and to classify the epilepsy syndrome in patients. 14 About 30% of the patients with epilepsy are not seizure-free while on anti-epileptic drugs (AEDs). These patients, with uncontrolled epileptic seizures and in whom two or more Chapter 1 12AEDs have failed, are commonly referred to as having refractory or intractable epilepsy. Patients with intractable epilepsy, depending on their preferences and comorbidities, may be eligible for several other treatments such as vagus nerve stimulation, deep brain stimulation, the ketogenic diet and surgery depending on the type and localization of the epilepsy. Economic impactAlthough the impact of interventions on population health is vital, it is also important to determine the role of different interventions in contributing to other socially desirable goals, such as improving patients' quality of life and reducing societal costs. Societal costs include healthcare and other (inter-sectoral) costs such as productivity losses. In addition, due to scarcity of resources and rising costs in the Dutch healthcare system, economic evaluations are becoming more important for decision-makers and healthcare reimbursement companies. In 2011, in The Netherlands, costs of epilepsy were about 248.7 million euro, that is 4.8% of the total healthcare costs spent on neurological conditions. 15 This is comparable to the cost of epilepsy in other western countries. 6,7 Furthermore, healthcare costs attributable to epilepsy are rising, especially in th...