Search NASA⌕ Search

SEARCH · Search NASA

Results for “Probabilistic risk assessment”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14
All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Brace For Impact – It’s Coming, Do You Know What to Do With It?

Long-duration human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for providing in-mission medical care. Compared with the International Space Station, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to define and quantitatively estimate human system risk attributable to medical conditions. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and medical trade space analysis tool being developed by NASA to advance medical system design for exploration missions. IMPACT has made a number of enhancements on the Integrated Medical Model, the PRA tool currently used by NASA. These updates include a novel medical evidence base baselined to a long duration, deep space exploration environment; an expanded medical condition list; and a trade space analysis capability (e.g. comparing risk profiles and mass/volume constraints for medical capabilities and resources). IMPACT core functionality includes quantification of a medical capability set and assisting with identification of specific medical resources/hardware for exploration missions. In addition, IMPACT provides sophisticated trade space capabilities to estimate how human system risk varies with changes to the mission architecture or medical capability set. This presentation will provide a brief overview of the IMPACT tool, discuss representative use cases, and show example results.

Benjamin Easter↗
NASA NTRSDate not supplied

Impact Outputs for A Representative Extended Duration Artemis Mission

BACKGROUND: As NASA and private industry begin preparation for long-duration spaceflight, quantifying the impact that potential human health and performance capabilities have on crew health outcomes is imperative for medical risk mitigation. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to estimate these outcomes. OVERVIEW: As NASA prepares to return to the Moon, medical system planning has already begun for extended Artemis missions, which will see humans spending months at a time in cis-lunar space and on the surface of the Moon. The Long Duration Lunar Orbital and Lunar Surface (LDLOLS) design reference mission (DRM) lasts 9 months, including 3 months on the lunar surface, and involves 2 male and 2 female crewmembers. LDLOLS assumes no extravehicular activities (EVAs) in orbit, but, while on the lunar surface, involves 2-4 EVAs/month in a pressurized rover and 2-4 EVAs/month in an unpressurized rover or on foot. This DRM assumes a physician level Crew Medical Officer with commensurate knowledge, skills, and abilities. The IMPACT tool was utilized to estimate in-flight medical risk for this mission. More specifically, 100,000 simulations of this DRM were modeled, and overall estimates for loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost (TTL; a measure of disability) were calculated. A recommended medical capability set, with appropriate mass and volume constraints, was also generated. DISCUSSION: This abstract reviews the IMPACT-derived risk for these mission outcomes with and without treatment, a macroscopic look at the total mass and volume necessary for full diagnostic and treatment capability, and how these change with input mission parameters.

J G Steller↗
NASA NTRSDate not supplied

Derivation of the Most Influential Medical Conditions for An Extended Duration Artemis Mission

BACKGROUND: The risk of loss of mission due to medical conditions may be influenced by loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost. Predicting what medical conditions are most likely to lead to crew morbidity and mortality may influence medical system design, clinical capability prioritization, and research strategies. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to assess these risks. OVERVIEW: A team of subject matter experts (SME) from a variety of medical disciplines developed a consensus-based process to determine 120 of the most clinically relevant medical conditions for long-duration exploration missions (LDEMs) . This IMPACT Condition List (ICL) expanded upon previous work done for Integrated Medical Model (IMM). For each condition a best-case and worst-case definition were derived. These definitions were used to identify probability of occurrence, proportion of cases that are best case vs. worst case, clinical phase duration, and risk of outcomes (task time loss [TTL], RTDC, and LOCL) for both treated and untreated states. These data were sources from existing spaceflight databases (e.g. Longitudinal Survey of Astronaut Health), relevant models (e.g. the ISS fire model), and/or terrestrial literature. Each condition was then tied to diagnostic and therapeutic resources and capabilities. IMPACT was then run for the LDLOLS DRM (see Abstract #2 for this panel). DISCUSSION: This abstract will present the process for generating the IMPACT condition list, the relevant data for each clinical condition, and present results for the ten most influential conditions impacting LOCL, RTDC, and TTL for a representative extended duration Artemis mission.

A Nelson↗
NASA NTRSDate not supplied

Determining the Most Influencing Medical Conditions in MEDPRAT’s SIN Directed Graph

INTRODUCTION: The Susceptibility Inference Network (SIN) is a network of medical conditions, part of the Medical Extensible Probabilistic Risk Assessment Tool (MEDPRAT) developed by NASA to assess human health and medical risk to space exploration missions. The SIN is subject matter expert informed and acts as a prototype that provides relationships and dependencies between events modeled by MEDPRAT. Each vertex in the SIN has a weight which evaluates the severity of having the condition regardless of the progression from or to that condition. In this presentation, we consider two statistics to measure that stand alone risk: Quality Time Lost (QTL) and Loss of Crew Life (LOCL). Our goal is to identify the medical conditions that contribute the most to crew members QTL and LOCL risks due to progression of conditions in the network. We investigate how different computation parameters result in different condition rankings and address the choice of parameters that allows appropriate interventions to ensure space mission success. METHODS: The Katz score, one of many centrality measures created for ranking purposes in network analysis, takes into account all possible walks through the network, penalizing each additional step in a walk by a factor α called the Katz parameter. The literature does not provide specific values for the choice of α. We derive an analytical relationship between α and the maximum path length which has influence on the Katz score and ranking. Based on the probability of progression of each condition in the SIN, we identify that maximum path length of interest and calculate α that is then used in the Katz formula to rank the conditions in the SIN. RESULTS AND CONCLUSION: The effective probabilities of the SIN matrix generally fall below 10−6, which is below the level of the least influencing condition in the set. This corresponds to the probability of at most six consecutive progressions of a condition. Consequently, we calculate the Katz Parameter α and get 0.32. We rank the medical conditions and find that Acute Radiation Symptom is the condition the most prone to contribute to quality time loss due to progression.

risk analysis↗
NASA NTRSDate not supplied

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

From May 8th to June 9th, 2023, I had the opportunity to participate in an experiential learning experience at Johnson Space Center in Houston, TX with Exploration Medical Capability (ExMC), an element of the NASA Human Research Program. During this research experience, I was not only able to work on the above titled research project, but also gain an immense exposure to the field of aerospace medicine, make numerous connections within the field, tour NASA facilities, as well as travel to the Aerospace Medical Association Annual Conference (AsMA) in New Orleans. To briefly introduce my project, it is well understood that the medical capabilities available to crew medical officers (CMOs) on the International Space Station will be different than the capabilities available and needed during deep space exploration missions to the Moon, Mars, and beyond. Ground support is particularly limited due to distance, communication delays (or lack of communication), and lack of resupply. Therefore, to support medical care by CMOs on these missions, robust clinical decision support systems (CDSSs) must be designed. The recent publication and public launch of generative artificial intelligence (AI) tools based upon large language models (LLM) such as ChatGPT provides the opportunity to create a smart assistant for onboard triage, diagnosis, and treatment of medical conditions. Ultimately, the overall purpose of the project was to research what AI tools currently exist or are in development, and to see how they might be implemented onboard during exploration class spaceflights of the future. The ExMC element is actively developing several tools to be used in preparation for and during deep space exploration missions. One of those tools, known as IMPACT, is a probabilistic risk assessment model which can be used to propose a desired medical system (based on mass and volume) and suggest the clinical outcomes likely to occur for a design reference mission (DRM). The group recently presented the IMPACT model and a DRM of interest titled “Modified Long Duration Lunar Orbital and Lunar Surface” (mLDLOLS) at the recent AsMA conference. The mLDLOLS mock mission is a 9 month and 6-day deep space exploration mission consisting of time in Moon’s orbit (3 months on the Gateway space station), on the lunar surface (3 months within habitat), and another 3 months on Gateway before return to Earth. For this DRM, IMPACT ultimately outlined a preferred medical system that was then associated with medical conditions considered to be most likely based on frequency, most likely to cause astronaut task time loss (TTL), most likely to cause return to definitive care (RTDC), and most likely cause loss of crew life (LOCL). IMPACT also highlighted the medical capabilities/skills that would be required to care for those medical conditions, such as performing a history of present illness or musculoskeletal exam with ultrasound. The primary objective of the project was to perform a survey of the AI tools and systems applicable to the conditions outlined for the proposed mLDLOLS mission. Using PubMed (including most relevant MeSH terms) and Google Scholar, we then created a robust annotated bibliography organized by condition. The 56-page and over 500 reference annotated bibliography was subsequently used to create a review outline that would become the basis for drafting of a future publication. For the review outline, we took those medical conditions researched within the annotated bibliography (condition-based approach) and deployed a systems-based approach, combining those medical conditions and related tools into ten categories. These categories included general/all-purpose CDSSs, tools to diagnose or manage respiratory, dermatologic, neurologic, auditory and vestibular, ophthalmic, musculoskeletal, infection-associated, and gynecologic conditions, as well as tools that could be deployed in the setting of trauma/emergency. With the completion of the 30-page outline, we then began drafting the review paper. To conclude the research experience, I presented the findings from our survey to the ExMC Clinical and Science team. With these objectives, I ultimately learned about the number of AI tools that exist today to assist medical professionals with the triage, diagnosis, and management of several medical conditions. These tools can span from chatbot assistants to help triage knee pain to vision transformer models that can identify ophthalmic conditions based on ocular surface images captured with a cell phone. We also highlighted the current gaps that exist in the literature alongside the advancements that are needed to make the desired CDSS for deep space exploration missions. With this experience, I certainly confirmed an existing career goal and identified several additional skills needed to become an aerospace medical doctor including knowledge of critical care in an extreme medicine setting, aerospace engineering and human integration systems, artificial intelligence, machine learning, and risk models. I also identified numerous transferable skills for this career goal including the basic knowledge of medicine (MD), deployment of the scientific method for critical thought about new scientific questions (PhD), review of published literature, including creating an annotated bibliography (PhD), as well as detailed scientific writing (PhD). The results of my research will likely guide the design of an all-encompassing onboard medical assistant for use during deep space exploration missions of the future. I plan on sharing the outcomes from this experience with my peers at a student seminar in the Fall semester on August 30th. During the seminar, I will detail the project, my experience at NASA and AsMA, as well as offer best practice guidelines for students entertaining similar experiences or careers. In conclusion, I would like to thank the WVU School of Medicine, Research and Graduate Education office, as well as NASA ExMC for the unwavering support of this life-changing experience.

Ryan A. Lacinski↗
NASA NTRSDate not supplied

Spaceflight Over the Last Ten Years: Failures and Fix-ups 2013 - 2022 RAMS XV Conference

This project is an overview and analysis of the past ten years (2013 – present) in global spaceflight, highlighting the orbital launches of countries, particularly the failures that occurred, the reasons they occurred, and a breakdown of the related statistics and background information. The analysis is conducted from a perspective of reliability and maintainability engineering and Probabilistic Risk Assessment (PRA) to formulate a quantifiable understanding of the data and how it is pertinent to Safety and Mission Assurance (SMA) in spaceflight. There is a breakdown by country or group, timelines, and number of launches. The failures over the years are categorized, all given a broad analysis of subsystem failures and details of events. A few failures are given a more in-depth analysis of root causes and failure modes determined by their unique or common nature. The data is retrieved from online, publicly available sources.

Quinn Slaugenhoupt↗
NASA NTRSDate not supplied

Improving Quantification of Medical Evacuation Risk for Human Spaceflight in the IMPACT Model

Traditionally, mission planners have used a heuristic and qualitative approach to design medical systems based on prior experience however this approach may result in high variability and implicit bias to design and could put missions and crewmembers at risk. The Informing Mission Planning through Analysis of Complex Tradespaces (IMPACT) tool is a probabilistic risk assessment tool designed by NASA to model medical risk in long duration missions outside of low earth orbit (LEO). This tool can quantify risk metrics such as risk of crewmember death, loss of crew task time, and the need for medical evacuation to better inform and augment the more traditional approach to medical system design. The risk metric of Return to Definitive Care (RTDC) represents the likelihood of requiring medical evacuation and has been difficult to quantify in a reliable and standardized manner. Initial development of the RTDC metric was constrained due to the complexity of a medical evacuation decision and the lack of prior spaceflight data and this presentation will discuss the review and improvement process used to increase model accuracy and fidelity.

Prashant Parmar↗
NASA NTRSDate not supplied

Supply and Resource Management to Progressively Enable EIMO

BACKGROUND: Current medical operations in Low Earth Orbit (LEO) allow for real-time audio-video communication with a flight surgeon at mission control, resupply, and medical evacuation to earth on the order of hours. As mission profiles change from LEO to the Moon, Mars, and beyond, medical risk as a contribution to overall mission risk is anticipated to rise substantially. Concurrently, due to the distance, the medical systems on board vehicles proposed for these mission types are expected to have reduced mass and volume allocation. Together, astronaut crews will be at a higher risk of major medical events, be required to perform a broader set of tasks, and have substantially reduced resources and support to do so. Earth Independent Medical Operations (EIMO) aims to identify and fill the gaps present in this progressively changing paradigm. OVERVIEW: Medical supplies, resources, and skills are central to spaceflight medical systems. Vehicles used for non-LEO missions are anticipated to be smaller and thus the medical system will also need to have reduced mass, volume, and power. Medical resources are another form of consumable and may need resupply or pre-deployment to meet crew needs. One particular concern is the degradation of medications which become less efficacious and potentially toxic with time, particularly given environmental conditions such as temperature, humidity, oxygen, and radiation which have not yet been fully studied. Supply and resource management in LEO is dependent on resupply, however the supply chain of transporting equipment does not yet have a clear infrastructure for missions beyond LEO. DISCUSSION: EIMO is intended to systemically identify and fill these gaps with forward-looking solutions. In mission monitoring of resources with technology like RFID, improving medical resource longevity, targeted resupply and careful pre-mission planning will be central to facilitate crew health and performance. One approach to optimizing resources is the Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool, which uses probabilistic risk assessment (PRA) to quantitatively predict medical risk and identify resources and skills that mitigate this risk. This evidence based, quantitative analysis prediction tool and several other approaches to meeting the challenge of supply and resource management are discussed.

Arian Anderson↗
NASA NTRSDate not supplied

CHP-PRA: Sensorimotor Countermeasures Proof of Concept

The capabilities included in Crew Health and Performance (CHP) systems are designed to keep the crew healthy, happy, and productive. In doing so, the CHP system allows reductions in human related risks to be realized. All human missions, though particularly future Artemis and Mars missions, have constraints on the mass and volume allocated to the CHP system. Thus, trades must be made on how to best buy down risk while still meeting other requirements. Understanding how different CHP capabilities influence medical, performance, and long-term health risks is key to making informed choices among these trades. To address this, an integrated CHP Probabilistic Risk Assessment (PRA) model is being developed. Much like how IMPACT is designed to allow medical resource trades informed by medical risks, CHP PRA will enable analogous trades in human system risks across all CHP functions and capabilities. There are 29 Human System Risk Board (HSRB) risk areas to consider for model implementation. This effort focused solely on the implementation of countermeasures associated with sensorimotor risk. The framework and lessons learned from this proof of concept will benefit the implementation of other risks and countermeasures. Astronauts experience sensorimotor changes when entering or exiting a microgravity environment. While most sensorimotor issues are resolved within a few days, they pose a serious risk to crew health and performance during the adaptation period. This adaptation period aligns with gravity transitions and key mission phases where the crew members may be required to complete challenging tasks ideally with an undisturbed sensorimotor system. Countermeasures such as training or pharmaceuticals can be used to mitigate risk. This effort began by identifying physiological changes to the sensorimotor system that could lead to functional performance decrements or medical conditions and potential countermeasures, so that the overall effect of sensorimotor disturbance on human risk could be captured. We then selected example countermeasures, mapped relationships between countermeasures and outcomes, and used results from existing sensorimotor investigations to define the relationship between a sensorimotor countermeasure and subsequent performance of a sensorimotor-affected task. Specifically, using shuttle landing performance data, we compared the use or absence of inflight training capabilities to yield a relative performance change that can be applied to the prediction of the risk associated with manual control performance in future missions, as depicted in the figure. This sensorimotor proof of concept demonstrates how HRP research information can be transformed into quantifiable relationships to describe changes in HSRB medical and performance risks.

Caroline R Austin↗
NASA NTRSDate not supplied

Strategies for Quantifying Human Space Flight Performance in the Crew Health and Performance System

The Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) team at NASA Glenn Research Center is planning a customized approach to quantify human spaceflight performance changes with respect to changes to the CHP system functions and capabilities. Using the Directed Acyclic Graphs (DAG) initiated by NASA’s Human Systems Risk Board (HSRB) [1], the team is surveying potential candidate models and novel strategies that generate metrics suitable for supporting decision making related to how the CHP system may influence human system performance risk. One such investigation includes classic Human Reliability Analysis (HRA) models. Traditionally, HRA methods estimate the occurrence of human errors and their impact on the success of an activity when designing and operating a system. While humans perceive, interpret, decide on, and carry out a course of action, the factors affecting performance and error likelihood are commonly referred to as performance shaping factors (PSFs). Originally developed to alleviate safety concerns related to nuclear power plant operations, HRA methods such as THERP [2] and CREAM [3] dismantle an activity into tasks, requiring elemental steps to be executed, and assess their failure due to predefined PSFs. In this study, we compare generic HRA methods and those that incorporate some human spaceflight aspects, such as sleep conditions (SCREAM [4]), with respect to how they may be adopted to capture performance with an intention to mitigate detrimental outcomes elucidated by the HSRB DAGs. We suggest strategies to quantify astronaut performance specific to spaceflight activities and illustrate how such concepts may help in optimizing the CHP system capabilities with respect to Artemis missions.

dag↗
NASA NTRSDate not supplied

Medical Resource Set Bulky Item Trade Space Analysis for Spaceflight Medical Risk

The NASA engineering community utilizes event-driven and fault-tree probabilistic techniques to classify risks in the space environment by taking advantage of the inherent knowledge of complex spaceflight system design and testing to quantify failure risk. In harmonizing the risk of human space flight, answering the question of ‘How do we balance health, performance and resource risks with other engineering risks on long duration space missions?’ remains a deeply challenging and largely qualitative practice. The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) is one aspect of the efforts by NASA’s Human Research Program (HRP) to quantitatively assess the impact of health and performance risk. One of MEDPRAT’s key features is its high degree of computational efficiency. Coupled with the HRP High Performance Compute cluster located at NASA’s Glenn Research Center, MEDPRAT runs millions of simulated missions in a matter of minutes. This degree of computational efficiency provides the novel opportunity to explore the relationship between medical set mass, volume, and medical resource size. Of particular interest for future human spaceflight missions are ‘bulky’ items, medical resources like devices, which occupy a large portion of the small, allocated mass and volume for the medical set leaving less room for other resources. This talk will present results showing the quantitative impact of forced inclusion of several bulky items across a variety of medical kit constraints, and the effect that a potential research investment into reducing the bulky item mass and volume may have on risk.

Lauren Mcintyre↗
NASA NTRSDate not supplied

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗
NASA NTRS2024

Quantifying Risk to Improve Medical System Design for Long Duration Artemis Missions: A Demonstration of NASA's IMPACT Tradespace Analysis Tool

BACKGROUND NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. A greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the evacuation of ill or injured crew. Mass, volume, and power will be limited while higher demands will be placed on the crews to manage medical events. NASA’s Moon to Mars exploration strategy outlines increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human system risk attributable to medical conditions and use these estimates to advance medical system design. METHODS IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and tradespace analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; a large increase in the number of medical resources and the flexibility of their use; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to mimic a foundational exploration Artemis mission. The DRM profile includes outbound transit on Orion, Gateway space station rendezvous in lunar orbit, 6 months on the Lunar surface with extravehicular activity (EVA), return rendezvous with Gateway, and transit back to Earth. RESULTS/DISCUSSION: Overall, IMPACT successfully quantified medical risk and derived an optimal medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to medical risk were decompression sickness, trauma, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions and performed as expected. This demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Arian Anderson↗
NASA NTRSDate not supplied

Baseline Medical System Translation for the Impact Medical Database

NASA has developed a new evidence-based data-driven probabilistic risk assessment and tradespace analysis tool as a successor to the Integrated Medical Model (IMM). This updated decision support tool is known as IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces). Whereas IMM focuses on the resources and risks associated with International Space Station (ISS) and Low Earth Orbit (LEO) missions, IMPACT estimates the frequency and consequences of medical conditions that might arise during exploration missions. One of the services offered by IMM is a series of generic or baseline medical systems associated with typical mission types or DRMs (Design Reference Missions), such that requestors may prioritize questions pertaining to the mission itself over the medical supplies indicated by the model outputs for that DRM. In a mission focused request, the appropriate baseline medical system is used in place of a prepared or optimized medical kit. In preparation, an effort was undertaken to create baseline systems of medical resources within IMPACT suitable for typical DRMs. Using an existing baseline medical system within IMM’s Integrated Medical Evidence Database (iMED) as a starting point, the resources found within the medical kit were compared to and substituted for equivalent resources available within the IMPACT MD (Medical Database). In consultation with clinicians with knowledge of IMPACT’s MD, each resource was matched as closely as possible to a similarly purposed resource in IMPACT, seeking to preserve the treatment capabilities and procedures offered by the IMM medical system while reconciling the differences in modeled resources and medical conditions between the models. To demonstrate the efficacy of this work, a prototype ISS medical system in IMPACT was translated from the baseline used in the IMM. The appropriate medical system was then run through its associated medical model to compare and validate the resultant risks and risk mitigation provided by each baseline ISS medical kit.

S Schwartz↗
NASA NTRSDate not supplied

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery↗
NASA NTRSDate not supplied

Sensorimotor Application of Proposed Methods to Combine the Effects of Multiple Countermeasures for PRisM

Risk associated with human systems is challenging to quantify but is critical for the mission planning and decision making required to enable future Lunar and Martian missions. To address this gap, the Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) project is developing an integrated computational model for CHP mission risk. Much like how MEDPRAT is designed to allow medical resource trades informed by medical risk, CHP-PRA will enable analogous trades in human system risks across multiple CHP functions and capabilities. Human performance is one component of the risk intended to be captured by CHP-PRA through the Performance Risk Model (PRisM). The sensorimotor risk area provides a good frame of reference for investigating the structure of a performance model because most tasks that astronauts are expected to perform require input from the sensory system and/or movement/motor control. Additionally, sensorimotor countermeasures are an area of particular concern for NASA’s Human Research Program because of the increased sensorimotor risk associated with surface operations in Lunar and Martian missions. Thus, a tool that can quickly compare risk reductions of potential countermeasures would be beneficial in guiding research and development of effective countermeasures. In this proof of concept, we present a systematic way to combine multiple performance data sets for humans subjected to different countermeasures such that we can predict the countermeasure(s) that optimize astronaut performance on relevant tasks. PRisM assumes that both the tests that are used to measure countermeasure effectiveness (input data) and the tasks we use to represent astronaut performance, can be broken down and represented as a function/vector of the human systems required to perform that test/task. Through mathematical combination, test data are used to predict performance on astronaut tasks that use similar systems. We propose that when combining countermeasures evaluated using the same test, that only one value should be used to represent their combined effectiveness. We start our analysis with the assumption that two countermeasures together will perform better than each countermeasure individually. Our initial implementation of this framework compares various space motion sickness countermeasures and the most up to date analysis will be demonstrated at the IWS.

Caroline R Austin↗
NASA NTRSDate not supplied

Quantifying the Sensitivity of Condition Incidence Parameters in the Evidence Library

One approach to quantifying spaceflight risk at NASA makes use event driven probabilistic techniques. The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) is such a tool that estimates medical risk metrics via simulation and enables optimization of medical resources subject to mission constraints [1]. Previous analyses have informed medical set composition, exercise countermeasures, and water intake, where each analysis quantifies the risk associated with proposed variations in system design. As future mission profiles extend beyond Low-Earth Orbit (LEO) and lengthen in duration, understanding these risks and contributing factors is critical. MEDPRAT employs Monte Carlo sampling techniques to simulate missions and track the occurrence of medical events. These events follow fault-tree-like progressions through levels of severity and mitigation via medical treatment to many possible outcomes and these are reported throughout the mission. Making this possible, are the medical databases that contain evidence gathered by the Human Research Program (HRP). Quantifying the impact of uncertainty or variability in the input data is an important step in evaluating the credibility of modeling and simulation results. In this work, we investigate the sensitivity of medical risk metrics with respect to the condition incidence parameters within the Evidence Library (EL) [2] as the medical database input for MEDPRAT. The medical conditions, contained in the EL, are equipped with incidence rates that describe the likelihood that the condition will occur. These incidence rates reflect historical spaceflight data or when appropriate, terrestrial data. In this presentation, we will explore how uncertainty in these rates propagate to the medical risk described by MEDPRAT. These results identify the conditions and parameters with the largest contribution to medical risks.

Ian Lim↗
NASA NTRSDate not supplied

LLMs and GenAI Tools to Depict Contributions of Human Systems to Spaceflight Tasks Execution

Recent advancements in Artificial Intelligence and Machine Learning (AI/ML) technologies, particularly Large Language Models (LLMs) capable of sophisticated syntax analysis, offer substantial potential in automating complex processes, thereby saving time and human resources. This study explores the development of an LLM-driven model designed to analyze and categorize a diverse set of Mars mission tasks into 18 predefined Human System Task Categories (HSTCs) based on their textual descriptions. As part of developing the Crew Health and Performance – Probabilistic Risk Assessment (CHP-PRA projects Performance Risk Model (PRisM) proof-of-concept, we established a framework to project performance scores from small-scale tests onto a preliminary list of Mars tasks. The foundation of our model was a comprehensive spreadsheet populated by NASA experts and clinicians, which detailed each Mars task alongside binary indicators of HSTC involvement. This dataset enabled the initial application of supervised ML, training and testing on existing HSTC labels. The HSTCs were originally defined from a medical system perspective, focusing on task impairments due to deteriorated human health. To expand our model's scope to include categories impacting performance, we face the challenge of generating binary labels (0 or 1) for new categories without pre-existing data. We address this by employing Generative AI (GenAI) software to determine whether a given task involved a new category by asking, "Does task A involve using category B?" We validate our approach by comparing the GenAI's binary classifications with the expert-provided labels for existing HSTCs. Notably, we utilize Ollama [4], a locally hosted GenAI tool that does not require cloud access, thus safeguarding NASA's proprietary data from unauthorized exposure. This study demonstrates the feasibility of leveraging cutting-edge AI tools to advance research, paving the way for automation and rapid decision-making in space exploration.

Mona Matar↗