<!-- 
American Society for Testing and Materials (ASTM) E31.25 Guideline Element Module (GEM) DTD last revised 1/30/2002 

PUBLIC IDENTIFIER "-//ASTM//DTD Guideline 1.0//EN"
SYSTEM IDENTIFIER "http://www.openhealth.org/ASTM/guideline.dtd"
XML Namespace "http://www.openhealth.org/ASTM/guideline"

-->
<!-- the default is not to prefix namespace qualified elements -->
<!ENTITY % NS.prefixed "IGNORE">
<!-- prefix xlink attributes -->
<!ENTITY % XLINK.namespace.prefixed "INCLUDE">
<!-- base module for E31.25 XML DTDs -->
<!ENTITY % ASTM.base.module PUBLIC "-//ASTM//DTD E31.25 Base 1.0//EN" "ASTM.E31.25.dtd">

%ASTM.base.module;
<!-- GEM namespace -->
<!ENTITY % GEM.xmlns.attrib "xmlns CDATA #FIXED 'http://www.openhealth.org/ASTM/guideline'">
<!-- common attributes -->
<!ENTITY % guideline.attrib "
	id ID #IMPLIED 
	xml:lang NMTOKEN #IMPLIED
	%xlink.simple.attrib;
">

<!ELEMENT guideline.document (guideline.header , guideline.body )>
<!ATTLIST guideline.document %GEM.xmlns.attrib; %astm.document.attrib;>

<!ELEMENT guideline.header  (identity | developer )*>
<!ATTLIST guideline.header %guideline.attrib; >

<!ELEMENT identity (guideline.title | citation | release.date | availability | status | companion.document | adaptation )*>
<!ATTLIST identity %guideline.attrib; >
<!ELEMENT guideline.title  %astm.content;>
<!ATTLIST guideline.title %guideline.attrib; >
<!ELEMENT citation  (#PCDATA | %ASTM.Mix; | guideline.length )*>
<!ATTLIST citation %guideline.attrib; >
<!ELEMENT guideline.length  %astm.content;>
<!ATTLIST guideline.length %guideline.attrib; >
<!ELEMENT release.date  %astm.content;>
<!ATTLIST release.date %guideline.attrib; >
<!ELEMENT availability  (#PCDATA | %ASTM.Mix; | electronic | print | contact )*>
<!ATTLIST availability %guideline.attrib; >
<!ELEMENT electronic  %astm.content;>
<!ATTLIST electronic %guideline.attrib; >
<!ELEMENT print  %astm.content;>
<!ATTLIST print %guideline.attrib; >
<!ELEMENT contact  %astm.content;>
<!ATTLIST contact %guideline.attrib; >
<!ELEMENT status  %astm.content;>
<!ATTLIST status %guideline.attrib; >
<!ELEMENT companion.document  (#PCDATA | %ASTM.Mix; | patient.resource )*>
<!ATTLIST companion.document %guideline.attrib; >
<!ELEMENT patient.resource  %astm.content;>
<!ATTLIST patient.resource %guideline.attrib; >
<!ELEMENT adaptation  %astm.content;>
<!ATTLIST adaptation %guideline.attrib; >


<!ELEMENT developer  (developer.name | committee.name | funding | endorser | comparable.guideline )*>
<!ATTLIST developer %guideline.attrib; >
<!ELEMENT developer.name  (#PCDATA | %ASTM.Mix; | developer.type )*>
<!ATTLIST developer.name %guideline.attrib; >
<!ELEMENT developer.type  %astm.content;>
<!ATTLIST developer.type source (ngc) "ngc">
<!ATTLIST developer.type id ID #IMPLIED>
<!ATTLIST developer.type Options CDATA #IMPLIED>
<!ELEMENT committee.name  (#PCDATA | %ASTM.Mix; | committee.expertise | committee.member  )*>
<!ATTLIST committee.name %guideline.attrib; >
<!ELEMENT committee.expertise  %astm.content;>
<!ATTLIST committee.expertise %guideline.attrib; >
<!ELEMENT committee.member  (#PCDATA | %ASTM.Mix; | member.expertise )*>
<!ATTLIST committee.member %guideline.attrib; >
<!ELEMENT member.expertise  %astm.content;>
<!ATTLIST member.expertise %guideline.attrib; >
<!ELEMENT funding  %astm.content;>
<!ATTLIST funding %guideline.attrib; >
<!ELEMENT endorser  %astm.content;>
<!ATTLIST endorser %guideline.attrib; >
<!ELEMENT comparable.guideline  %astm.content;>
<!ATTLIST comparable.guideline %guideline.attrib; >

<!ELEMENT guideline.body (purpose | intended.audience | development.method | target.population | knowledge.components | testing | revision.plan )*>
<!ATTLIST guideline.body %guideline.attrib; >

<!ELEMENT purpose (main.focus | category | rationale | objective | available.option | implementation.strategy | health.outcome | exception )*>
<!ATTLIST purpose %guideline.attrib; >
<!ELEMENT main.focus %astm.content;>
<!ATTLIST main.focus %guideline.attrib;  >
<!ELEMENT category  %astm.content;>
<!ATTLIST category source (ngc) "ngc">
<!ATTLIST category id ID #IMPLIED>
<!ATTLIST category Options CDATA #IMPLIED>
<!ELEMENT rationale  %astm.content;>
<!ATTLIST rationale %guideline.attrib; >
<!ELEMENT objective  %astm.content;>
<!ATTLIST objective %guideline.attrib; >
<!ELEMENT available.option  %astm.content;>
<!ATTLIST available.option %guideline.attrib; >
<!ELEMENT implementation.strategy  %astm.content;>
<!ATTLIST implementation.strategy %guideline.attrib; >
<!ELEMENT health.outcome  %astm.content;>
<!ATTLIST health.outcome %guideline.attrib; >
<!ELEMENT exception  %astm.content;>
<!ATTLIST exception %guideline.attrib; >

<!ELEMENT intended.audience  (users | care.setting )*>
<!ATTLIST intended.audience %guideline.attrib; >
<!ELEMENT users  (#PCDATA | %ASTM.Mix; | clinical.specialty | professional.group )*>
<!ATTLIST users %guideline.attrib; >
<!ELEMENT clinical.specialty  %astm.content;>
<!ATTLIST clinical.specialty  source   (ngc )  'ngc'
                              id      ID     #IMPLIED
                              Options CDATA  #IMPLIED >
<!ELEMENT professional.group  %astm.content;>
<!ATTLIST professional.group  source   (ngc )  'ngc'
                              id      ID     #IMPLIED
                              Options CDATA  #IMPLIED >
<!ELEMENT care.setting  %astm.content;>
<!ATTLIST care.setting %guideline.attrib; >

<!ELEMENT development.method  (description.evidence.collection | evidence.time.period | method.evidence.grading | description.evidence.combination | cost.analysis | specification.harm.benefit | quantification.harm.benefit | role.value.judgment | role.patient.preference | qualifying.statement )*>
<!ATTLIST development.method %guideline.attrib; >
<!ELEMENT description.evidence.collection  (#PCDATA | %ASTM.Mix; | method.evidence.collection | number.source.documents )*>
<!ATTLIST description.evidence.collection %guideline.attrib; >
<!ELEMENT method.evidence.collection  %astm.content;>
<!ATTLIST method.evidence.collection  source   (ngc )  'ngc'
                                      id      ID     #IMPLIED
                                      Options CDATA  #IMPLIED >
<!ELEMENT number.source.documents  %astm.content;>
<!ATTLIST number.source.documents %guideline.attrib; >
<!ELEMENT evidence.time.period  %astm.content;>
<!ATTLIST evidence.time.period %guideline.attrib; >
<!ELEMENT method.evidence.grading  (#PCDATA | %ASTM.Mix; | rating.scheme )*>
<!ATTLIST method.evidence.grading  source   (ngc )  'ngc'
                                   id      ID     #IMPLIED
                                   Options CDATA  #IMPLIED >
<!ELEMENT rating.scheme  %astm.content;>
<!ATTLIST rating.scheme %guideline.attrib; >
<!ELEMENT description.evidence.combination  (#PCDATA | %ASTM.Mix; | method.evidence.combination )*>
<!ATTLIST description.evidence.combination %guideline.attrib; >
<!ELEMENT method.evidence.combination  %astm.content;>
<!ATTLIST method.evidence.combination  source   (ngc )  'ngc'
                                       id      ID     #IMPLIED
                                       Options CDATA  #IMPLIED >
<!ELEMENT cost.analysis  %astm.content;>
<!ATTLIST cost.analysis %guideline.attrib; >
<!ELEMENT specification.harm.benefit  %astm.content;>
<!ATTLIST specification.harm.benefit %guideline.attrib; >
<!ELEMENT quantification.harm.benefit  %astm.content;>
<!ATTLIST quantification.harm.benefit %guideline.attrib; >
<!ELEMENT role.value.judgment  %astm.content;>
<!ATTLIST role.value.judgment %guideline.attrib; >
<!ELEMENT role.patient.preference  %astm.content;>
<!ATTLIST role.patient.preference %guideline.attrib; >
<!ELEMENT qualifying.statement  %astm.content;>
<!ATTLIST qualifying.statement %guideline.attrib; >

<!ELEMENT target.population  (eligibility | age | sex )*>
<!ATTLIST target.population %guideline.attrib; >
<!ELEMENT eligibility  (#PCDATA | %ASTM.Mix; | inclusion.criterion | exclusion.criterion )*>
<!ATTLIST eligibility %guideline.attrib; >
<!ELEMENT inclusion.criterion  %astm.content;>
<!ATTLIST inclusion.criterion %guideline.attrib; >
<!ELEMENT exclusion.criterion  %astm.content;>
<!ATTLIST exclusion.criterion %guideline.attrib; >
<!ELEMENT age  %astm.content;>
<!ATTLIST age  source   (ngc )  'ngc'
               id      ID     #IMPLIED
               Options CDATA  #IMPLIED >
<!ELEMENT sex  %astm.content;>
<!ATTLIST sex  source   (ngc )  'ngc' id  ID  #IMPLIED  Options CDATA  #IMPLIED >
<!ELEMENT knowledge.components  (recommendation | definition | algorithm )*>
<!ATTLIST knowledge.components %guideline.attrib; >
<!ELEMENT recommendation  (#PCDATA | %ASTM.Mix; | conditional | imperative )*>
<!ATTLIST recommendation  %guideline.attrib; >
<!ELEMENT conditional  (#PCDATA | %ASTM.Mix; | decision.variable | action | reason | evidence.quality | recommendation.strength | flexibility | logic | cost | link | reference | certainty )*>
<!ATTLIST conditional %guideline.attrib; >
<!ELEMENT decision.variable  (#PCDATA | %ASTM.Mix; | value | decision.variable.description | test.parameter | decision.variable.cost )*>
<!ATTLIST decision.variable  source  CDATA #IMPLIED  id ID  #IMPLIED
decision.variable.id CDATA  #IMPLIED >
<!ELEMENT value  %astm.content;>
<!ATTLIST value %guideline.attrib; >
<!ELEMENT decision.variable.description  %astm.content;>
<!ATTLIST decision.variable.description %guideline.attrib; >
<!ELEMENT test.parameter  (#PCDATA | %ASTM.Mix; | sensitivity | specificity | predictive.value )*>
<!ATTLIST test.parameter %guideline.attrib; >
<!ELEMENT sensitivity  %astm.content;>
<!ATTLIST sensitivity %guideline.attrib; >
<!ELEMENT specificity  %astm.content;>
<!ATTLIST specificity %guideline.attrib; >
<!ELEMENT predictive.value  %astm.content;>
<!ATTLIST predictive.value %guideline.attrib; >
<!ELEMENT decision.variable.cost  %astm.content;>
<!ATTLIST decision.variable.cost  source CDATA  #IMPLIED  id  ID  #IMPLIED >
<!ELEMENT action  (#PCDATA | %ASTM.Mix; | action.benefit | action.risk.harm | action.description | action.cost )*>
<!ATTLIST action source  CDATA  #IMPLIED  id  ID #IMPLIED
   action.id CDATA  #IMPLIED >
<!ELEMENT action.benefit  %astm.content;>
<!ATTLIST action.benefit %guideline.attrib; >
<!ELEMENT action.risk.harm  %astm.content;>
<!ATTLIST action.risk.harm %guideline.attrib; >
<!ELEMENT action.description  %astm.content;>
<!ATTLIST action.description %guideline.attrib; >
<!ELEMENT action.cost  %astm.content;>
<!ATTLIST action.cost %guideline.attrib; >
<!ELEMENT reason  %astm.content;>
<!ATTLIST reason %guideline.attrib; >
<!ELEMENT evidence.quality  %astm.content;>
<!ATTLIST evidence.quality %guideline.attrib; >
<!ELEMENT recommendation.strength  %astm.content;>
<!ATTLIST recommendation.strength %guideline.attrib; >
<!ELEMENT flexibility  %astm.content;>
<!ATTLIST flexibility %guideline.attrib; >
<!ELEMENT logic  %astm.content;>
<!ATTLIST logic %guideline.attrib; >
<!ELEMENT cost  %astm.content;>
<!ATTLIST cost %guideline.attrib; >
<!ELEMENT link  %astm.content;>
<!ATTLIST link %guideline.attrib; >
<!ELEMENT reference  %astm.content;>
<!ATTLIST reference %guideline.attrib; >
<!ELEMENT certainty  %astm.content;>
<!ATTLIST certainty %guideline.attrib; >

<!ELEMENT imperative  (#PCDATA | %ASTM.Mix; |directive | reason | evidence.quality | recommendation.strength | flexibility | logic | cost | link | reference | certainty  )*>
<!ATTLIST imperative %guideline.attrib; >
<!ELEMENT directive  (#PCDATA | %ASTM.Mix; |directive.benefit | directive.risk.harm | directive.description | directive.cost  )*>
<!ATTLIST directive source CDATA  #IMPLIED id ID #IMPLIED
     directive.id CDATA  #IMPLIED >
<!ELEMENT directive.benefit  %astm.content;>
<!ATTLIST directive.benefit %guideline.attrib; >
<!ELEMENT directive.risk.harm  %astm.content;>
<!ATTLIST directive.risk.harm %guideline.attrib; >
<!ELEMENT directive.description  %astm.content;>
<!ATTLIST directive.description %guideline.attrib; >
<!ELEMENT directive.cost  %astm.content;>
<!ATTLIST directive.cost %guideline.attrib; >
<!ELEMENT definition  (#PCDATA | %ASTM.Mix; | term )*>
<!ATTLIST definition %guideline.attrib; >
<!ELEMENT term  (#PCDATA | %ASTM.Mix; | term.meaning )*>
<!ATTLIST term %guideline.attrib; >
<!ELEMENT term.meaning  %astm.content;>
<!ATTLIST term.meaning %guideline.attrib; >
<!ELEMENT algorithm  (#PCDATA | %ASTM.Mix; |action.step | conditional.step | branch.step | synchronization.step )*>
<!ATTLIST algorithm %guideline.attrib; >
<!ELEMENT action.step  %astm.content;>
<!ATTLIST action.step %guideline.attrib; >
<!ELEMENT conditional.step  %astm.content;>
<!ATTLIST conditional.step %guideline.attrib; >
<!ELEMENT branch.step  %astm.content;>
<!ATTLIST branch.step %guideline.attrib; >
<!ELEMENT synchronization.step  %astm.content;>
<!ATTLIST synchronization.step %guideline.attrib; >
<!ELEMENT testing  (external.review | pilot.testing )*>
<!ATTLIST testing %guideline.attrib; >
<!ELEMENT external.review  (#PCDATA | %ASTM.Mix; | review.method )*>
<!ATTLIST external.review %guideline.attrib; >
<!ELEMENT review.method  %astm.content;>
<!ATTLIST review.method  source   (ngc )  'ngc'
                         id      ID     #IMPLIED
                         Options CDATA  #IMPLIED >
<!ELEMENT pilot.testing  %astm.content;>
<!ATTLIST pilot.testing %guideline.attrib; >
<!ELEMENT revision.plan  (expiration | scheduled.review )*>
<!ATTLIST revision.plan %guideline.attrib; >
<!ELEMENT expiration  %astm.content;>
<!ATTLIST expiration %guideline.attrib; >
<!ELEMENT scheduled.review  %astm.content;>
<!ATTLIST scheduled.review %guideline.attrib; >