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TM_E_2210_
_12
Designation:E221012An American National StandardStandard Specification forGuideline Elements Model version 3(GEM III)DocumentModel for Clinical Practice Guidelines1This standard is issued under the fixed designation E2210;the number immediately following the designation indicates the year oforiginal adoption or,in the case of revision,the year of last revision.A number in parentheses indicates the year of last reapproval.Asuperscript epsilon()indicates an editorial change since the last revision or reapproval.1.Scope1.1 This specification updates a standard representation forstoring and organizing the heterogeneous information con-tained in clinical practice guidelines.This specification isintended to facilitate translation of natural-language guidelinedocuments into a format that can be processed by computers.Itcan be used to represent document content throughout theentire guideline life cycle.Information at both high and lowlevels of abstraction can be accommodated.This specificationis based on the guideline elements model(GEM)created at theYale Center for Medical Informatics and designed to serve asa comprehensive XML-based guideline document representa-tion.1.2 This specification refers to and makes use of recommen-dations from the World Wide Web consortium,the W3C.21.3 Standard Guideline SchemaThis specification definesa standard Schema for clinical practice guidelines.The Schemais included in Annex A1.1.4 This standard does not purport to address all of thesafety concerns,if any,associated with its use.It is theresponsibility of the user of this standard to establish appro-priate safety and health practices and determine the applica-bility of regulatory requirements prior to use.2.Referenced Documents2.1 W3C World Wide Web Consortium:XML 1.0 Recommendation3XML Schema 1.043.Terminology3.1 Definitions:3.1.1 document type definition(DTD)the formal definitionof the elements,structures,and rules for enabling platform-independent data access via XML,or for marking up a giventype of SGML document.3.1.2 extensible markup language(XML)standard fromthe World Wide Web Consortium(W3C)that provides fortagging of information content within documents,offering ameans of representation of content in a format that is bothhuman and machine readable.Through the use of customizablestyle sheets and schemas,information can be represented in auniform way,allowing for interchange of both content(data)and format(metadata).3.1.3 health level 7(HL7)a standards organization tradi-tionally focused on standards for healthcare information inter-change.HL7 messages are the dominant standard for peer-to-peer exchange of clinical text-based information.Morerecently,HL7 has developed a comprehensive object model ofthe healthcare enterprise and the first level of an XML clinicaldocument architecture.3.1.4 HL7 clinical document architecture(CDA)a docu-ment markup standard for the structure and semantics ofexchanged clinical documents.A clinical document is a docu-mentation of observations and other services with the follow-ing characteristics:persistence,stewardship,potential forauthentication,wholeness,and human readability.A CDAdocument is a defined and complete information object that canexist outside of a message and can include text,sounds,andother multimedia content.3.1.5 hypertext markup language(HTML)the languageused in creating a web page.Its origin is an implementation ofSGML DTD.It provides tags regarding the way a documentshould be displayed in the text of an HTML document,whichact as commands that a browser interprets when downloadingan HTML file.3.1.6 namespacesprovide a simple method for qualifyingelement and attribute names used in XML documents.This isaccomplished by associating a particular tag set by associatinga prefix with a URI reference.XML namespaces provides amechanism for authoring compound documents(documentsconsisting of elements and attributes from multiple DTDs or1This specification is under the jurisdiction of ASTM Committee E31 onHealthcare Informatics and is the direct responsibility of Subcommittee E31.35 onHealthcare Data Analysis.Current edition approved March 1,2012.Published March 2012.Originallyapproved in 2002.Last previous edition approved in 2006 as E2210 06.DOI:10.1520/E2210-12.2http:/www.w3.org3http:/www.w3.org/XML/4http:/www.w3.org/XML/SchemaCopyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959.United States1 schemas)in such a way that will provide global identificationwithout collisions of names that are the same but are useddifferently.3.1.7 parsera specialized software program that recog-nizes markup in a document and differentiates the content fromthe markup.A parser that reads a DTD and checks and reportson markup errors is a validating XML parser.A parser can bebuilt into an XML editor to prevent incorrect tagging and tocheck whether a document contains all the required elements.3.1.8 XML Schemaprovides a means for defining thedetailed structure,co