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KCE ProcessBook

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This repository provides access to KCE methods and process notes. You can download the documents directly or click on the title to view a summary, the full reference (with .RIS to download) and the table of contents.

 This site is currently under reconstruction.

KCE Reports 411C (2026)

Summary


How to cite this report?

Jespers Vicky, Verleye Leen, Costa Elena, Vlayen Joan, Struyf Thomas. KCE Process Note: Research Methods for guidelines – update 2025. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2026. KCE Reports 411. (DOI: 10.57598/R411C)

Table of Contents

  1. Introduction
  2. general aspects of guideline developments
  3. Defining the scope and developing review questions
  4. Critical appraisal of the literature
  5. GRADE for interventions
  6. GRADE for diagnostic tests and test-treatment management strategies
  7. Recommendations
  8. Review and validation
  9. Dissemination
  10. Manual KCE - Validated assessment tools

Files

KCE Process Note (2016)

Summary


How to cite this report?

Mistiaen P, Leroy R, Van de Voorde C, Stordeur S, Van den Heede K. HSR Process Notes: Literature review and
international comparison. Methods. Brussels: Belgian Health Care Knowledge Centre (KCE). 2016.

Table of contents

  1. Introduction
  2. Literature review
  3. International comparison

Files

KCE Reports 400C (2025)

Summary

In Belgium, cost-effectiveness is one of the criteria used by public authorities to assess applications for reimbursement of medicines and Class 1 medical devices, i.e. products for which the applicant claims added therapeutic value and for which a higher price may be charged. For other interventions as well (surgical procedures, vaccines, disease prevention strategies, screening programmes, etc.), economic evaluations and budget impact analyses provide valuable support for the efficient use of limited resources. This guideline is the result of the second update of the KCE guideline on economic evaluations in health and budget impact analyses. The aim is to improve the relevance, methodological quality, transparency and consistency of these economic evaluations of health interventions in Belgium.

How to refer to this report?

Neyt Mattias, Thiry Nancy, Cleemput Irina. Belgian guidelines for economic evaluations and budget impact analyses: third edition. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2025. KCE Reports 400C. DOI: 10.57598/R400C.

Table of contents

  1. Background
  2. Objectives
  3. Methods
  4. Brief overview of the Belgian guidelines and general remarks
  5. Guidelines for health economics evaluation
  6. Guidelines for budget impact analyses
  7. Discussion

Files

KCE Reports 342C (2021)

Summary

For a long time, decisions on whether to reimburse a health intervention have taken into account the impact of the illness and its treatment on patient life expectancy and quality of life. For life expectancy, there is a clear measure: time. However, quality of life is harder to quantify. Yet it is essential to know how to measure it in order to be able to make comparisons between patients suffering from different conditions and/or receiving different treatments.

EQ-5D is a tool that is widely used for measuring health-related quality of life (in other words, the specific impact of health or illness on quality of life). Its EQ-5D-5L version describes 3,125 states of health to which a “value” is attributed reflecting quality of life, called the “utility score”. For the first time, KCE has developed a set of values (valuation matrix) for EQ-5D-5L, based on an extensive survey among a representative sample of the Belgian population.

This valuation matrix proposes, for each health issue described by EQ-5D, a quality of life value reflecting the average preferences of the Belgian population.

When it comes to assessing health interventions, treatments or new technologies, these utility scores make it possible to choose between length of life and quality of life. 

The study was cofunded by EuroQol Research Foundation.

How to refer to this report?

Bouckaert Nicolas, Gerkens Sophie, Devriese Stephan, Cleemput Irina. An EQ-5D-5L value set for Belgium – How to value health-related quality of life? Health Services Research (HSR). Brussels. Belgian Health Care Knowledge Centre (KCE). 2021. KCE Reports 342. DOI: 10.57598/R342C. 

Table of contents

  1. Introduction
  2. Methods
  3. Data analysis
  4. Results: the Belgian EQ-5D-5L value set
  5. Discussion and conclusion

Files

KCE Reports 408C (2025)

Summary

In the context of KCE research, qualitative methods can provide a deeper, more concrete understanding of the topic under investigation than purely quantitative data, as well as valuable insights regarding its wider context. Their aim is not just to describe, but also to obtain more meaningful explanations of a phenomenon. They can also be useful in generating hypotheses. Qualitative research methods are particularly valuable in research on the organisation of healthcare (known as Health Services Research or HSR), but they can also be used in other types of projects like Health Technology Assessments (HTA) or the development of Good Clinical Practice guidelines (GCP).

How to cite this report?

Dauvrin Marie, Kohn Laurence, Christiaens Wens, Benahmed Nadia, Cornelis Justien, Desomer Anja, Paradis Julie, Cleemput Irina. KCE Process Note: Qualitative Research Methods. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2025. KCE Reports 408C. DOI: 10.57598/R408C. 

Table of contents

  1. Why this report?
  2. Aims
  3. Methodology
    PART 1
  4. What are the specificities of qualitative research?
  5. Frequently asked questions about qualitative research studies
  6. Preparing a qualitative research study 
  7. Ethical issues specific to qualitative health research
  8. Quality and validity of qualitative research methods
  9. Reflexivity in qualitative health research
    PART 2

Files

KCE Process Note

Summary


How to cite this report?

Christiaens Wens, Kohn Laurence. Introduction to systems thinking in health services research. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2018.

  • Download the bibliographical reference  (.RIS)

Table of contents

  1. Why use systems thinking?
  2. What is a system?
  3. The origin of system thinking and its link with complexity
  4. A paradigm shift
  5. Two approaches within systems thinking
  6. Systems thinking and qualitative research

Files

  • pdf soon available

KCE Reports 340 (2021)

Summary

This process note aims at providing guidance on how to involve patients at various stages of a research process. It follows the publication of the Position Paper on Patient Involvement in KCE research in 2019 (KCE Report 320). The process note describes potential barriers and proposes practical solutions to help researchers to actively involve patients in their research projects.

This process note is accompanied by a practical guide of animation techniques that may help to involve patients in a practical, effective and pleasant way. These techniques could also be used with other target groups. 

Both of these publications are living documents: they will be updated based on the future experiences of KCE researchers when involving patients.  

How to cite this report?

Kohn Laurence, Dauvrin Marie, Cleemput Irina. Patient involvement in policy research at KCE: process note. Methods. Brussels. Health Care Knowledge Centre (KCE). 2021. KCE Reports 340. DOI: 10.57598/R340C. 

Table of Contents

  1. Introduction
  2. Methods
  3. Process note on "Patient involvement"

Files

KCE Reports 386C (2024)

Summary

Classic KCE reports are often time- and resource-consuming, but in a rapidly changing healthcare environment, there is sometimes a need for faster assessments of available evidence. To provide faster scientific answers to pressing healthcare questions, the KCE has developed a new ‘accelerated’ methodology.

How to refer to this report?

Roberfroid Dominique, Castanares-Zapatero Diego, Chalon Patrice, Costa Elena, Dauvrin Marie, de Meester Christophe, Desomer Anja, Fairon Nicolas, Hourlay Luc, Jonckheer Pascale, Kohn Laurence, Lefèvre Mélanie, Levy Muriel, Ombelet Sien, San Miguel Lorena, Schönborn Claudia, Van de Voorde Carine, Van den Heede Koen. Expedited Scientific Research and Reporting (ESRO) at KCE. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2024. KCE Reports 386C. DOI: 10.57598/R386C. 

Table of contents

  1. Rationale
  2. Objectives and methods
  3. General ESRO framework at KCE
  4. Expedited literature reviews
  5. Expedited international comparisons
  6. Rapid qualitative research
  7. Automation

Files

Process note Web survey (2015)

Summary


How to refer to this document?

Kohn Laurence, Devos Carl. Process Note: Websurvey@kce. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2015.

Table of contents

  1. Background
  2. Process
  3. How to prepare a survey?
  4. Sampling
  5. Recruitment of the participants
  6. Questionnaire building
  7. Put the questionnaire online
  8. Pilot the online survey
  9. Test-retest (optional)
  10. Launch the final survey
  11. Send reminders
  12. Close the survey
  13. Insert data manually
  14. Analysis and reporting

Files

  • procedure_websurvey.pdf
  • Appendices
    • limesurvey_kce_manual20201409.pdf
    • Plugin_Delphi_for_Limesurvey_140920.pdf

Process Note Search for evidence (2016)

Summary

A protocol for carrying out a review is equivalent to, and as important as, a protocol for a primary research study. A review is less likely to be biased if the questions are well developed beforehand, and the methods that will be used to answer them are decided on before gathering the necessary data and drawing inferences. In the absence of a protocol, it is possible that study selection and analysis will be unduly driven by (a presumption of) the findings.

A search strategy consists of several aspects. The research question (in a structured format, see Building a search question) should be used as a guide to direct the search strategy. For electronic searches, it is important to list the databases in which studies will be sought. Other sources can be consulted in order to identify all relevant studies. These include reference lists from relevant primary and review articles, journals, grey literature and conference proceedings, research registers, researchers and manufacturers, and the internet.

In practice, it is uncommon for a single search to cover all the questions being addressed within a review. Different questions may be best answered by different databases, or may rely on different study types. Authors are encouraged to take an iterative approach to the search, carrying out a search for high-level evidence first. After evaluating the results of this first search, the questions may need to be redefined and subsequent searches may need to be focused on more appropriate sources and study types.

In some cases, directly relevant good-quality evidence syntheses (secondary sources), such as good-quality systematic reviews or Health Technology Assessments (HTA), will be available on some of the issues that fall within the remit of the review. In these circumstances reference will be made to the existing evidence rather than repeating work that already has been done. All HTA reports or systematic reviews that are identified must be evaluated on their quality and must be shown to have followed an acceptable methodology before they can be considered for use in this way.

In other cases existing evidence may not be directly relevant or may be found to have methodological weaknesses. In these cases, existing evidence cannot be used in the review. Nevertheless, excluded systematic reviews or HTA reports still can be a useful source of references that might be used later on in the review.

In conclusion, literature searches for the KCE should follow an iterative approach, searching for evidence syntheses first and subsequently complementing this search by searching for original studies. Various resources are listed in the following paragraph.

How to refer to this report?

Vlayen Joan, Chalon Patrice, Anja Desomer, Pascale.Jonckheer, Jo Robays. Process Note: Search for evidence. Methods. Brussels. Belgian Health Care Knowledge Centre (KCE). 2016.

Table of contents

  1. Introduction
  2. Building a search question
  3. Searching electronic sources
  4. Searching supplementary sources
  5. Searching for evidence on adverse effects
  6. Selecting studies
  7. Quality assessment of studies
  8. Data extraction
  9. Analysing and interpreting results
  10. Reporting of the literature review

Files

  • Process note Search for evidence (.PDF)
  • Appendices
    • AGREEII.pdf 
    • Case-control studies_template.docx 
    • Cochrane Collaboration's Risk of Bias Tool.doc 
    • Cohort studies_template.docx 
    • evidence tables_final.docx 
    • KCEProcessbook_Amstar2-checklist.docx 
    • limesurvey_kce_manual20201409.pdf 
    • Plugin_Delphi_for_Limesurvey_140920.pdf 
    • procedure_websurvey.pdf 
    • process_04_template_-_search_strategy_1.doc 
    • process_04_template_-_search_strategy_1.odt 
    • Process_06_Template_StudiesSelection_20200716_0.xls 
    • Template QUADAS 2 tool.doc 
    • Template Risk of Bias tool.doc