Cochrane · systematic review · CD001903

Ketogenic diets for drug‐resistant epilepsy

Martin-McGill, KJ, Bresnahan, R, Levy, RG, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Epilepsy4 versionsAMSTAR 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
24
current version
GRADE rated
18
No studies
6
Included studies
NR
No studies 6 · 25%Ungraded 0 · 0%Very low 15 · 62.5%Low 3 · 12.5%Moderate 0 · 0%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

Show all 4 versions

Ketogenic diet (KD) compared to usual care for children with drug‐resistant epilepsy

Population: children (aged 1 to 18 years) with drug‐resistant epilepsy
6 questions
OutcomeEffectEvidenceStatus / GRADE
Seizure freedom (100% reduction in seizure frequency)
Ketogenic diet (KD) vs usual care
RR 3.16 [1.2, 8.35]4 studies · 385 participantsVery low
Downgraded: risk of bias, imprecision
50% or greater reduction in seizure frequency
Ketogenic diet (KD) vs usual care
5.8 [3.48, 9.65]4 studies · 385 participantsLow
Downgraded: risk of bias, imprecision
Adverse effects
Ketogenic diet (KD) vs usual care
no estimate extracted5 studies · 425 participantsLow
Downgraded: risk of bias, imprecision
Cognition and behaviour
Ketogenic diet (KD) vs usual care
no estimate extracted1 study · 57 participantsVery low
Downgraded: risk of bias, imprecision
Quality of life
Ketogenic diet (KD) vs usual care
OR 161 study · 57 participantsVery low
Downgraded: risk of bias, imprecision
Treatment withdrawal
Ketogenic diet (KD) vs usual care
RR 1.08 [0.74, 1.57]5 studies · 425 participantsLow
Downgraded: risk of bias, imprecision

Ketogenic diet (KD) compared to usual care for adults with drug‐resistant epilepsy

Population: adults (aged 16 years and over) with drug‐resistant epilepsy
6 questions
OutcomeEffectEvidenceStatus / GRADE
Seizure freedom
Ketogenic diet (KD) vs usual care
no estimate extracted2 studies · 141 participantsVery low
Downgraded: risk of bias, imprecision
50% or greater reduction in seizure frequency
Ketogenic diet (KD) vs usual care
RR 5.03 [0.26, 97.68]2 studies · 141 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Adverse effects
Ketogenic diet (KD) vs usual care
no estimate extracted2 studies · 141 participantsVery low
Downgraded: risk of bias, imprecision
Cognition and behaviour
Ketogenic diet (KD) vs usual care
no estimate extractedNRNo studies
Quality of life
Ketogenic diet (KD) vs usual care
no estimate extractedNRNo studies
Treatment withdrawal
Ketogenic diet (KD) vs usual care
RR 5.38 [0.42, 69.53]2 studies · 141 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency

Ketogenic diets (KDs) compared with other KDs for children with drug‐resistant epilepsy

Population: children (aged 4 months to 16 years) with drug‐resistant epilepsy
6 questions
OutcomeEffectEvidenceStatus / GRADE
Seizure freedom (100% reduction in seizure frequency)
Ketogenic diets (KDs) vs other KDs
no estimate extracted5 studies · 286 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Seizure reduction (50% or greater reduction in seizure frequency)
Ketogenic diets (KDs) vs other KDs
no estimate extracted5 studies · 286 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Adverse effects
Ketogenic diets (KDs) vs other KDs
no estimate extracted5 studies · 286 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Cognition and behaviour
Ketogenic diets (KDs) vs other KDs
no estimate extractedNRNo studies
Quality of life
Ketogenic diets (KDs) vs other KDs
no estimate extractedNRNo studies
Attrition rate
Ketogenic diets (KDs) vs other KDs
no estimate extracted5 studies · 286 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency

Ketogenic diets (KDs) compared with other KDs for adults with drug‐resistant epilepsy

Population: adults (aged 18 years and over) with drug‐resistant epilepsy
6 questions
OutcomeEffectEvidenceStatus / GRADE
Seizure freedom (100% reduction in seizure frequency)
Ketogenic diets (KDs) vs other KDs
no estimate extracted1 study · 80 participantsVery low
Downgraded: risk of bias, imprecision
Seizure reduction (50% or greater reduction in seizure frequency)
Ketogenic diets (KDs) vs other KDs
no estimate extracted1 study · 80 participantsVery low
Downgraded: risk of bias, imprecision
Adverse effects
Ketogenic diets (KDs) vs other KDs
no estimate extracted1 study · 80 participantsVery low
Downgraded: risk of bias, imprecision
Cognition and behaviour
Ketogenic diets (KDs) vs other KDs
no estimate extractedNRNo studies
Quality of life
Ketogenic diets (KDs) vs other KDs
no estimate extractedNRNo studies
Attrition rate
Ketogenic diets (KDs) vs other KDs
no estimate extracted1 study · 80 participantsVery low
Downgraded: risk of bias, imprecision