default namespace gem = "http://www.openhealth.org/ASTM/guideline"
guideline.attrib =
	attribute id {xsd:ID}?
	attribute xml:lang {xsd:NMTOKEN}?
	xlink.attrib?
source.attrib = attribute source{"ngc"},
               attribute id {xsd:ID}?,
               attribute Options {text}?
			   
root = element guideline.document{
			astm.document.attrib,
			guideline.header,
			guideline.body
			}

guideline.header = element guideline.header{
		guideline.attrib,(identity | developer )*
		}


identity = element identity{guideline.attrib,
		(guideline.title | citation | release.date | availability | status | 
		companion.document | adaptation )*
		}
<!ATTLIST identity %guideline.attrib; >
guideline.title  = element # { guideline.attrib, astm.content }
<!ATTLIST guideline.title %guideline.attrib; >
citation  = element citation{ guideline.attrib,(astm.content | guideline.length )*}
<!ATTLIST citation %guideline.attrib; >
guideline.length  = element # { guideline.attrib, astm.content }
<!ATTLIST guideline.length %guideline.attrib; >
release.date  = element # { guideline.attrib, astm.content }
<!ATTLIST release.date %guideline.attrib; >
availability  (#PCDATA | %ASTM.Mix; | electronic | print | contact )*>
<!ATTLIST availability %guideline.attrib; >
electronic  = element # { guideline.attrib, astm.content }
<!ATTLIST electronic %guideline.attrib; >
print  = element # { guideline.attrib, astm.content }
<!ATTLIST print %guideline.attrib; >
contact  = element # { guideline.attrib, astm.content }
<!ATTLIST contact %guideline.attrib; >
status  = element # { guideline.attrib, astm.content }
<!ATTLIST status %guideline.attrib; >
companion.document  (#PCDATA | %ASTM.Mix; | patient.resource )*>
<!ATTLIST companion.document %guideline.attrib; >
patient.resource  = element # { guideline.attrib, astm.content }
<!ATTLIST patient.resource %guideline.attrib; >
adaptation  = element # { guideline.attrib, astm.content }
<!ATTLIST adaptation %guideline.attrib; >


developer  (developer.name | committee.name | funding | endorser | comparable.guideline )*>
<!ATTLIST developer %guideline.attrib; >
developer.name  (#PCDATA | %ASTM.Mix; | developer.type )*>
<!ATTLIST developer.name %guideline.attrib; >
developer.type  = element # { guideline.attrib, astm.content }
<!ATTLIST developer.type source (ngc) "ngc">
<!ATTLIST developer.type id ID #IMPLIED>
<!ATTLIST developer.type Options CDATA #IMPLIED>
committee.name  (#PCDATA | %ASTM.Mix; | committee.expertise | committee.member  )*>
<!ATTLIST committee.name %guideline.attrib; >
committee.expertise  = element # { guideline.attrib, astm.content }
<!ATTLIST committee.expertise %guideline.attrib; >
committee.member  (#PCDATA | %ASTM.Mix; | member.expertise )*>
<!ATTLIST committee.member %guideline.attrib; >
member.expertise  = element # { guideline.attrib, astm.content }
<!ATTLIST member.expertise %guideline.attrib; >
funding  = element # { guideline.attrib, astm.content }
<!ATTLIST funding %guideline.attrib; >
endorser  = element # { guideline.attrib, astm.content }
<!ATTLIST endorser %guideline.attrib; >
comparable.guideline  = element # { guideline.attrib, astm.content }
<!ATTLIST comparable.guideline %guideline.attrib; >

guideline.body (purpose | intended.audience | development.method | target.population | knowledge.components | testing | revision.plan )*>
<!ATTLIST guideline.body %guideline.attrib; >

purpose (main.focus | category | rationale | objective | available.option | implementation.strategy | health.outcome | exception )*>
<!ATTLIST purpose %guideline.attrib; >
main.focus = element # { guideline.attrib, astm.content }
<!ATTLIST main.focus %guideline.attrib;  >
category  = element category { guideline.attrib, source,attrib,astm.content }

rationale  = element # { guideline.attrib, astm.content }
<!ATTLIST rationale %guideline.attrib; >
objective  = element # { guideline.attrib, astm.content }
<!ATTLIST objective %guideline.attrib; >
available.option  = element # { guideline.attrib, astm.content }
<!ATTLIST available.option %guideline.attrib; >
implementation.strategy  = element # { guideline.attrib, astm.content }
<!ATTLIST implementation.strategy %guideline.attrib; >
health.outcome  = element # { guideline.attrib, astm.content }
<!ATTLIST health.outcome %guideline.attrib; >
exception  = element # { guideline.attrib, astm.content }
<!ATTLIST exception %guideline.attrib; >

intended.audience  = element intended.audience{ guideline.attrib,
	(users | care.setting )*}
<!ATTLIST intended.audience %guideline.attrib; >
users  = element users{ guideline.attrib,
			(astm.content | clinical.specialty | professional.group )*}

clinical.specialty  = element clinical.specialty { guideline.attrib, source.attrib, astm.content }
professional.group  = element professional.group { guideline.attrib, source.attrib, astm.content }
care.setting  = element care.setting { guideline.attrib, astm.content }
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; >
description.evidence.collection  (#PCDATA | %ASTM.Mix; | method.evidence.collection | number.source.documents )*>
<!ATTLIST description.evidence.collection %guideline.attrib; >
method.evidence.collection  = element # { guideline.attrib, astm.content }
<!ATTLIST method.evidence.collection  source   (ngc )  'ngc'
                                      id      ID     #IMPLIED
                                      Options CDATA  #IMPLIED >
number.source.documents  = element # { guideline.attrib, astm.content }
<!ATTLIST number.source.documents %guideline.attrib; >
evidence.time.period  = element # { guideline.attrib, astm.content }
<!ATTLIST evidence.time.period %guideline.attrib; >
method.evidence.grading  (#PCDATA | %ASTM.Mix; | rating.scheme )*>
<!ATTLIST method.evidence.grading  source   (ngc )  'ngc'
                                   id      ID     #IMPLIED
                                   Options CDATA  #IMPLIED >
rating.scheme  = element # { guideline.attrib, astm.content }
<!ATTLIST rating.scheme %guideline.attrib; >
description.evidence.combination  (#PCDATA | %ASTM.Mix; | method.evidence.combination )*>
<!ATTLIST description.evidence.combination %guideline.attrib; >
method.evidence.combination  = element # { guideline.attrib, astm.content }
<!ATTLIST method.evidence.combination  source   (ngc )  'ngc'
                                       id      ID     #IMPLIED
                                       Options CDATA  #IMPLIED >
cost.analysis  = element # { guideline.attrib, astm.content }
<!ATTLIST cost.analysis %guideline.attrib; >
specification.harm.benefit  = element # { guideline.attrib, astm.content }
<!ATTLIST specification.harm.benefit %guideline.attrib; >
quantification.harm.benefit  = element # { guideline.attrib, astm.content }
<!ATTLIST quantification.harm.benefit %guideline.attrib; >
role.value.judgment  = element # { guideline.attrib, astm.content }
<!ATTLIST role.value.judgment %guideline.attrib; >
role.patient.preference  = element # { guideline.attrib, astm.content }
<!ATTLIST role.patient.preference %guideline.attrib; >
qualifying.statement  = element # { guideline.attrib, astm.content }
<!ATTLIST qualifying.statement %guideline.attrib; >

target.population  (eligibility | age | sex )*>
<!ATTLIST target.population %guideline.attrib; >
eligibility  (#PCDATA | %ASTM.Mix; | inclusion.criterion | exclusion.criterion )*>
<!ATTLIST eligibility %guideline.attrib; >
inclusion.criterion  = element # { guideline.attrib, astm.content }
<!ATTLIST inclusion.criterion %guideline.attrib; >
exclusion.criterion  = element # { guideline.attrib, astm.content }
<!ATTLIST exclusion.criterion %guideline.attrib; >
age  = element # { guideline.attrib, astm.content }
<!ATTLIST age  source   (ngc )  'ngc'
               id      ID     #IMPLIED
               Options CDATA  #IMPLIED >
sex  = element # { guideline.attrib, astm.content }
<!ATTLIST sex  source   (ngc )  'ngc' id  ID  #IMPLIED  Options CDATA  #IMPLIED >
knowledge.components  (recommendation | definition | algorithm )*>
<!ATTLIST knowledge.components %guideline.attrib; >
recommendation  (#PCDATA | %ASTM.Mix; | conditional | imperative )*>
<!ATTLIST recommendation  %guideline.attrib; >
conditional  (#PCDATA | %ASTM.Mix; | decision.variable | action | reason | evidence.quality | recommendation.strength | flexibility | logic | cost | link | reference | certainty )*>
<!ATTLIST conditional %guideline.attrib; >
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 >
value  = element # { guideline.attrib, astm.content }
<!ATTLIST value %guideline.attrib; >
decision.variable.description  = element # { guideline.attrib, astm.content }
<!ATTLIST decision.variable.description %guideline.attrib; >
test.parameter  (#PCDATA | %ASTM.Mix; | sensitivity | specificity | predictive.value )*>
<!ATTLIST test.parameter %guideline.attrib; >
sensitivity  = element # { guideline.attrib, astm.content }
<!ATTLIST sensitivity %guideline.attrib; >
specificity  = element # { guideline.attrib, astm.content }
<!ATTLIST specificity %guideline.attrib; >
predictive.value  = element # { guideline.attrib, astm.content }
<!ATTLIST predictive.value %guideline.attrib; >
decision.variable.cost  = element # { guideline.attrib, astm.content }
<!ATTLIST decision.variable.cost  source CDATA  #IMPLIED  id  ID  #IMPLIED >
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 >
action.benefit  = element # { guideline.attrib, astm.content }
<!ATTLIST action.benefit %guideline.attrib; >
action.risk.harm  = element # { guideline.attrib, astm.content }
<!ATTLIST action.risk.harm %guideline.attrib; >
action.description  = element # { guideline.attrib, astm.content }
<!ATTLIST action.description %guideline.attrib; >
action.cost  = element # { guideline.attrib, astm.content }
<!ATTLIST action.cost %guideline.attrib; >
reason  = element # { guideline.attrib, astm.content }
<!ATTLIST reason %guideline.attrib; >
evidence.quality  = element # { guideline.attrib, astm.content }
<!ATTLIST evidence.quality %guideline.attrib; >
recommendation.strength  = element # { guideline.attrib, astm.content }
<!ATTLIST recommendation.strength %guideline.attrib; >
flexibility  = element # { guideline.attrib, astm.content }
<!ATTLIST flexibility %guideline.attrib; >
logic  = element # { guideline.attrib, astm.content }
<!ATTLIST logic %guideline.attrib; >
cost  = element # { guideline.attrib, astm.content }
<!ATTLIST cost %guideline.attrib; >
link  = element # { guideline.attrib, astm.content }
<!ATTLIST link %guideline.attrib; >
reference  = element # { guideline.attrib, astm.content }
<!ATTLIST reference %guideline.attrib; >
certainty  = element # { guideline.attrib, astm.content }
<!ATTLIST certainty %guideline.attrib; >

imperative  (#PCDATA | %ASTM.Mix; |directive | reason | evidence.quality | recommendation.strength | flexibility | logic | cost | link | reference | certainty  )*>
<!ATTLIST imperative %guideline.attrib; >
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 >
directive.benefit  = element # { guideline.attrib, astm.content }
<!ATTLIST directive.benefit %guideline.attrib; >
directive.risk.harm  = element # { guideline.attrib, astm.content }
<!ATTLIST directive.risk.harm %guideline.attrib; >
directive.description  = element # { guideline.attrib, astm.content }
<!ATTLIST directive.description %guideline.attrib; >
directive.cost  = element # { guideline.attrib, astm.content }
<!ATTLIST directive.cost %guideline.attrib; >
definition  = element definition{(astm.content | term )*}
<!ATTLIST definition %guideline.attrib; >
term  = element term{
			(astm.content  | term.meaning )*
			}
term.meaning  = element term.meaning { guideline.attrib, astm.content }
algorithm  = element algorithm {
		astm.content | (action.step | conditional.step | branch.step | synchronization.step )*
		}
action.step  = element # { guideline.attrib, astm.content }
<!ATTLIST action.step %guideline.attrib; >
conditional.step  = element # { guideline.attrib, astm.content }
branch.step  = element # { guideline.attrib, astm.content }
synchronization.step  = element # { guideline.attrib, astm.content }
testing  (external.review | pilot.testing )*>
external.review = element external.review{ (astm.content | review.method )*}
review.method  = element # { guideline.attrib, source.attrib, astm.content }
<!ATTLIST review.method  source   (ngc )  'ngc'
                         id      ID     #IMPLIED
                         Options CDATA  #IMPLIED >
pilot.testing  = element # { guideline.attrib, astm.content }
revision.plan  (expiration | scheduled.review )*>
expiration  = element # { guideline.attrib, astm.content }
scheduled.review  = element # { guideline.attrib, astm.content }