Locally derived clinical practice guidelines using a decision analysis model.

As health-care providers continually are faced with the need to identify the most cost-effective modalities when initiating therapy among many therapeutic options, standardized clinical guidelines become the foundation for decision making. This article discusses how decision analysis can be useful in the formulation of locally derived clinical practice guidelines. The following is an example of using decision analysis to evaluate data gathered within the institution, supplemented by peer-reviewed literature, to choose the most cost-effective agent in the treatment of chemotherapy-induced nausea and vomiting at the authors' institution.