ASTM E2210 - 12

VIP免费

Carl 2024-09-04 27 212.64KB 29 页 10星币

侵权投诉

Designation: E2210 −12 An American National Standard

Standard Speciﬁcation for

Guideline Elements Model version 3 (GEM III)—Document

Model for Clinical Practice Guidelines

This standard is issued under the ﬁxed designation E2210; the number immediately following the designation indicates the year of

original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A

superscript epsilon (´) indicates an editorial change since the last revision or reapproval.

1. Scope

1.1 This speciﬁcation updates a standard representation for

storing and organizing the heterogeneous information con-

tained in clinical practice guidelines. This speciﬁcation is

intended to facilitate translation of natural-language guideline

documents into a format that can be processed by computers. It

can be used to represent document content throughout the

entire guideline life cycle. Information at both high and low

levels of abstraction can be accommodated. This speciﬁcation

is based on the guideline elements model (GEM) created at the

Yale Center for Medical Informatics and designed to serve as

a 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.

1.3 Standard Guideline Schema—This speciﬁcation deﬁnes

a standard Schema for clinical practice guidelines. The Schema

is included in Annex A1.

1.4 This standard does not purport to address all of the

safety concerns, if any, associated with its use. It is the

responsibility 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 Documents

2.1 W3C World Wide Web Consortium:

XML 1.0 Recommendation

XML Schema 1.0

3. Terminology

3.1 Deﬁnitions:

3.1.1 document type deﬁnition (DTD)—the formal deﬁnition

of the elements, structures, and rules for enabling platform-

independent data access via XML, or for marking up a given

type of SGML document.

3.1.2 extensible markup language (XML)—standard from

the World Wide Web Consortium (W3C) that provides for

tagging of information content within documents, offering a

means of representation of content in a format that is both

human and machine readable. Through the use of customizable

style sheets and schemas, information can be represented in a

uniform 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. More

recently, HL7 has developed a comprehensive object model of

the healthcare enterprise and the ﬁrst level of an XML clinical

document architecture.

3.1.4 HL7 clinical document architecture (CDA)—a docu-

ment markup standard for the structure and semantics of

exchanged clinical documents. A clinical document is a docu-

mentation of observations and other services with the follow-

ing characteristics: persistence, stewardship, potential for

authentication, wholeness, and human readability. A CDA

document is a deﬁned and complete information object that can

exist outside of a message and can include text, sounds, and

other multimedia content.

3.1.5 hypertext markup language (HTML)—the language

used in creating a web page. Its origin is an implementation of

SGML DTD. It provides tags regarding the way a document

should be displayed in the text of an HTML document, which

act as commands that a browser interprets when downloading

an HTML ﬁle.

3.1.6 namespaces—provide a simple method for qualifying

element and attribute names used in XML documents. This is

accomplished by associating a particular tag set by associating

a preﬁx with a URI reference. XML namespaces provides a

mechanism for authoring compound documents (documents

consisting of elements and attributes from multiple DTDs or

This speciﬁcation is under the jurisdiction of ASTM Committee E31 on

Healthcare Informatics and is the direct responsibility of Subcommittee E31.35 on

Healthcare Data Analysis.

Current edition approved March 1, 2012. Published March 2012. Originally

approved in 2002. Last previous edition approved in 2006 as E2210 – 06. DOI:

10.1520/E2210-12.

http://www.w3.org

http://www.w3.org/XML/

http://www.w3.org/XML/Schema

schemas) in such a way that will provide global identiﬁcation

without collisions of names that are the same but are used

differently.

3.1.7 parser—a specialized software program that recog-

nizes markup in a document and differentiates the content from

the markup. A parser that reads a DTD and checks and reports

on markup errors is a validating XML parser. A parser can be

built into an XML editor to prevent incorrect tagging and to

check whether a document contains all the required elements.

3.1.8 XML Schema—provides a means for deﬁning the

detailed structure, content and semantics of XML documents.

XML Schema was approved as a W3C Recommendation

approved on 2 May 2001 and with a second edition incorpo-

rating many errata was published on 28 October 2004 that

provides a means for deﬁning the detailed structure, content

and semantics of XML documents. XML Schema deﬁnes the

elements that can appear within the document and the attributes

that can be associated with an element. It also deﬁnes the

structure of the document: which elements are child elements

of others, the sequence in which the child elements can appear,

and the number of child elements. It deﬁnes whether an

element is empty or can include text. The schema can also

deﬁne default values for attributes.

3.1.9 stylesheet—the XSL transformations (XSLT) de-

scribes a vocabulary recognized by an XSLT processor to

transform information from an organization in the source ﬁle

into a different organization suitable for continued downstream

processing. The extensible stylesheet language (XSL) de-

scribes a vocabulary recognized by a rendering agent to reify

abstract expressions of format into a particular medium of

presentation.

3.1.10 valid XML document—a document that is well-

formed, with internal or DOCTYPE reference to element

deﬁnition of tags within the document.

3.1.11 well-formed XML document—an XML document that

conforms to the syntax as speciﬁed by the W3C XML 1.0

recommendation.

3.1.12 World Wide Web Consortium (W3C)—develops in-

teroperable technologies (speciﬁcations, guidelines, software,

and tools) to lead the Web to its full potential as a forum for

information, commerce, communication, and collective under-

standing.

3.1.13 XHTML—HTML documents that are well formed

and can be processed by an XML parser.

3.1.14 XLL/XLINK/XPOINTER—XLL, the extensible link-

ing language, is divided into two parts, XLinks and XPointers.

XLink, the XML linking language, deﬁnes how one document

links to another document. XPointer, the XML pointer

language, deﬁnes how individual parts of a document are

addressed. XLinks point to a URI (in practice, a URL) that

speciﬁes a particular resource. The URL may include an

XPointer part that more speciﬁcally identiﬁes the desired part

or section of the targeted resource or document. XPointer, the

XML pointer language, deﬁnes an addressing scheme for

individual parts of an XML document. XLinks point to a URI

(in practice, a URL) that speciﬁes a particular resource. The

URI may include an XPointer part that more speciﬁcally

identiﬁes the desired part or element of the targeted resource or

document. XPointers use the same XPath syntax as XSL

transformations to identify the parts of the document they point

to, along with a few additional pieces.

3.2 Deﬁnitions of Terms Speciﬁc to This Standard:

3.2.1 clinical practice guidelines—systematically devel-

oped statements to assist practitioner and patient decisions

about appropriate healthcare for speciﬁc clinical circum-

stances.

3.2.2 guideline elements model (GEM)—an XML-based

guideline document model that promotes translation of natural

language guideline documents into a format that can be

processed by computers. Developed at the Yale Center for

Medical Informatics, GEM serves as the basis for this speci-

ﬁcation.

3.2.3 guidelines interchange format (GLIF)—a proposed

representation for guideline logic created by the INTERMED

Collaboratory.

3.2.4 national guidelines clearinghouse (NGC)—a website

sponsored by the U.S. Agency for Healthcare Quality and

Research that disseminates information about qualifying guide-

lines. It includes a structured vocabulary for describing several

aspects of guidelines.

3.3 GEM Deﬁnitions:

3.3.1 See Table A1.1 in Annex A1.

4. Signiﬁcance and Use

4.1 GEM Representation—The guideline elements model

(GEM) was created to unify representations created by health

services researchers and by informatics specialists. Speciﬁca-

tion E2210 Schema is based on the GEM knowledge represen-

tation. It is intended to be:

4.1.1 Comprehensive, that is, capable of expressing all the

knowledge contained in a guideline. Existing health services

models of guidelines are inadequate for expressing the com-

plexity of knowledge components in sufficient detail to facili-

tate electronic translations. On the other hand, existing infor-

matics models are insufficient to model constructs that express

and support guideline validity. Lack of conﬁdence in the

validity of guideline recommendations may ultimately limit

end user adherence.

4.1.2 Expressively adequate to express the complexities and

nuances of clinical medicine while remaining informationally

equivalent to the original guideline. Most tagged elements in

the Speciﬁcation E2210 Schema store the actual language of

the guideline, thereby remaining true to the original. Moreover,

this Schema does not require recommendation knowledge to be

structured in a temporal sequence, an often artiﬁcial transfor-

mation necessary for algorithmic representations.

Guidelines for Clinical Practice: From Development to Use, Institute of

Medicine, National Academy Press, Washington, DC, 1992.

http://ycmi.med.yale.edu

http://www.glif.org.

http://www.guideline.gov

E2210 − 12

4.1.3 Flexible, that is, a useful model must be able to deal

with the variety and complexity of guidelines. The representa-

tion should permit modeling at high and low levels of

granularity so that guidelines can be interpreted at different

levels of abstraction. The Speciﬁcation E2210 Schema allows

markup using high-level tags or deeper analysis using elements

from lower levels in the hierarchy. In addition, the open XML

document model can be modiﬁed easily if necessary to

accommodate missing semantic constructs.

4.1.4 Comprehensible, that is, it should match the stake-

holders’ normal problem-solving language and allow domain

experts to describe their knowledge with little effort. The

Speciﬁcation E2210 Schema markup does not require knowl-

edge of programming. The markup process parallels physical

highlighting of a document and should be learned easily by

nonprogrammers.

4.1.5 Shareable across institutions. The use of XML for

knowledge representation and markup provides unparalleled

cross-platform compatibility.

4.1.6 Reusable across all phases of the guideline life cycle.

4.2 Conformance—A document is tested for conformance to

this speciﬁcation by a validating XML parser according to the

W3C XML 1.0 recommendation.

A conformant document

must validate without either well-formedness or validity errors,

according to XML 1.0. A conformant document must also

conform to constraints expressed within the prose of this

speciﬁcation; however, this speciﬁcation does not express a

formal means of testing conformance to such additional

constraints. A document must be valid according to the Schema

speciﬁed in this speciﬁcation in order to conform to this

speciﬁcation.

4.3 Use—The Guideline Elements Model has been the

subject of considerable interest and application and has become

the leading exemplar of document-centered guideline knowl-

edge representation. It has been applied by national specialty

societies in the U.S. for guideline development. Shahar in

Israel has employed GEM within the DeGeL architecture to

create a digital guideline library.

In Paris, Georg and col-

leagues found the GEM representation to be superior to their

then current guideline system (ASTI) for encoding therapeutic

guidelines.GEM has been incorporated within the GUIDE

architecture in Pavia, Italy; it has been used to teach informat-

ics students about guidelines by Rector in the UK; it was

incorporated within the CPGA architecture by Purves in the

UK; and it is being used in New Zealand for referral guideline

dissemination. In Canada, Jones has used GEM to generate

tailored patient education materials and Kershaw has applied

the system to create a web-enabled best-evidence retrieval

system. GEM is featured and linked on the Open Clinical

website in the UK.

4.3.1 Workers at Yale have found that parsing guideline

recommendations into decision variables (and values), actions,

and directives facilitates their encoding in controlled vocabu-

laries such as SNOMED and LOINC and promotes the creation

of rules based on the recommendations.

5. Procedure

5.1 GEM Architecture—As shown in Fig. 1, the root

<schema> element contains three components:

<GuidelineDocument>, <GemBasicType>, and <GemCode-

Type>.. The next tier of the <GuidelineDocument> hierarchy

deﬁnes a series of high-level elements that include <Identity>,

<Developer>. <Purpose>, <IntendedAudience>,

<MethodOfDevelopment>, <TargetPopulation>,

<KnowledgeComponents>, <Testing>, <RevisionPlan>, and

<ImplementationPlan> elements. Each of these elements

comprises one or more additional levels of guideline con-

structs.

5.1.1 The named global complex data type <GemBasic-

Type> deﬁnes the “source,” “version,” “id,” and “lang” attri-

butes. The “source” attribute distinguishes whether an el-

ement’s content is explicitly stated within the guideline

document or was inferred by the person who performed the

markup and takes values of “explicit,” “inferred,” or “not_

deﬁned.” The “version” attribute deﬁnes the speciﬁc version of

the element.The “id” attribute deﬁnes a unique identiﬁer for

each element. The “lang” attribute indicates the language of the

text content.

5.1.2 The named global complex data type <GemCode-

Type> deﬁnes the”source,” “version,” “codeset,” “id,” and

“lang” attributes. The “source” attribute distinguishes whether

an element’s content is explicitly stated within the guideline

document or was inferred by the person who performed the

markup and takes values of “explicit,” “inferred,” or “not_

deﬁned.” The “version” attribute deﬁnes the speciﬁc version of

the element. The “codeset” attribute identiﬁes the name of the

dataset o f concept identiﬁers for each element. The “id”

attribute deﬁnes a unique identiﬁer for each element. The

“lang” attribute indicates the language of the text content.

5.2 Components:

5.2.1 Elements—Elements can appear as often as required.

Most elements store information that is literally presented in

the guideline text itself, for example, release date, name of

sponsoring organization, and recommendation text. Element

deﬁnitions are provided in Table A1.1.

5.2.2 Data Types—Elements are of type GemBasicType or

GemCodeType or contain the GemBasicType or GemCode-

Type attributes.

5.2.3 Annotations—Annotations contain deﬁnitions of ele-

ments.

5.2.4 Codes—The elements DecisionVariableCode,

ActionCode, DirectiveCode, RecommendationStrengthCode,

InclusionCriterionCode, ExclusionCriterionCode, and Scope-

Code contain letters or digits that are used for identiﬁcation or

selection purposes. The system from which the code originates

isspeciﬁed in the “codeset” attribute.

http://www.w3.org/TR/2000/REC-xml-20001006

Shahar, Y., Shalom, E., Mayaffit, A., Young, O., Galperin, M., Martins, S., et

al, “A Distributed, Collabaorative, Structuring Model for a Clinical-Guideline

Digital-Library,” Musen, M. A., editor, AMIA 2003 Symposium, Washington, DC,

2003, pp. 589-593.

E2210 − 12

文档加载中……请稍候！
如果长时间未打开，您也可以点击刷新试试。

下载文档到电脑，查找使用更方便

亲，本站95%以上的标准规范都面向会员免费，办理VIP会员下载更省钱，平均每篇不到2元

立即下载 VIP免费下载

摘要：

ASTM E2210 - 12 是国际标准组织 ASTM 制定的一项关于屋面系统用板式隔热材料的标准规范，主要适用于建筑屋顶结构中使用的聚异氰脲酸酯（PIR）或聚氨酯（PUR）硬质泡沫塑料板的性能要求与测试方法。该标准规定了材料的密度、压缩强度、尺寸稳定性、热阻值、吸水率及抗老化等关键指标，旨在确保隔热材料在长期使用中的可靠性与节能效果。版本中的“12”代表该标准于2012年发布，适用于建筑节能设计与施工中材料选型和质量控制。遵循此标准有助于提升屋顶系统的耐久性，减少热损失，适应不同气候条件下的

展开>> 收起<<

ASTM E2210 - 12.pdf

共29页,预览4页

还剩页未读，继续阅读

声明：本文档系会员上传，若文档所含内容侵犯了您的版权或隐私，请立即通知，我们立即给予侵权申诉删除！

ASTM E2210 - 12

相关推荐

开通VIP享超值会员特权

相关内容

热门标签

举报选择: