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All sourcesNASA NTRSDOE OSTI
NASA NTRS2018

Comparison of the Integrated Medical Model Predictions to Real World ISS and STS Observations

The Human Research Program funded the development of the integrated medical model (IMM) to quantify the medical component of overall mission risk. The IMM uses Monte Carlo methodology to integrate space flight and ground medical data to assess the probability of mission medical outcomes and resource utilization. To determine the credibility of IMM output the IMM project team completed two validation studies that compare IMM output to observed medical events from a selection of Shuttle Transportation System (STS) and International Space Station (ISS) missions.

validation↗
NASA NTRSDate not supplied

Datascope to Enable Earth Independent Medical Operations (EIMO)

BACKGROUND: NASA has amassed sixty years of knowledge and experience relevant to maintenance of crew health and performance in low earth orbit. The Apollo Program introduced the importance of ensuring progressively autonomous operational capability. Earth Independent Medical Operations (EIMO) will require a gradual shift in the balance of medical responsibility, management, and authority from terrestrial to space-based assets. Terrestrial assets will continue to be essential for pre-mission screening and planning in addition to maintenance of crew health and performance. However, new capabilities are needed to enable EIMO and the amount of data required to support these systems, and mitigate the impacts of data transmission delays and reduced bandwidth coupled with lack of cloud-like resources and on-board computing capacity that is currently unclear or operationally insufficient. OVERVIEW: The overall goal of EIMO is to develop artificial intelligence (AI)-based solutions to analyze crew health and performance data utilizing a clinical decision support system (CDSS) to provide crew medical officers (CMO) with the equivalent of real-time, on-board medical consults. The EIMO ecosystem is envisioned as a “system of systems” where embedded reference databases and real-time data streams from multiple input vectors continuously and seamlessly assess crew health and performance. EIMO will be designed to make recommendations to the CMO using multi-modal AI-based natural language processing and machine learning methods with interoperability to push/pull data within and between multiple vehicle and habitat architectures. DISCUSSION: Data flows and storage/retrieval capacity are severely constrained during space missions and the challenges will become even greater during exploration missions. Just as each past program from Mercury to the International Space Station (ISS) required rethinking the interaction between ground-based controllers and space-based crew, so too will future missions to the Moon and Mars. While the NASA High-Performance Spaceflight Computing Processor project aims to increase computational capacity by 100 times over current spaceflight computers, the projected deliverable still lags considerably behind what will be needed to enable an AI-driven CDSS. Restrictions in processing speed and data storage capacity, coupled with transmission bottlenecks and delays, necessitate definition and optimization of an integrated data architecture to enable a progressively autonomous medical capability.

Medical operations↗
DOE OSTI2021

Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology

Parkinson’s disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson’s patients. In this proof-of-concept study, we propose to use objective sensor data from the PKG and apply machine learning to cluster patients based on levodopa regimens and response. The resulting clusters are then used to enhance treatment planning by providing improved initial treatment estimates to supplement a physician’s initial assessment. We apply k-means clustering to a dataset of within-subject Parkinson’s medication changes—clinically assessed by the MDS-Unified Parkinson’s Disease Rating Scale-III (MDS-UPDRS-III) and the PKG sensor for movement staging. A random forest classification model was then used to predict patients’ cluster allocation based on their respective demographic information, MDS-UPDRS-III scores, and PKG time-series data. Clinically relevant clusters were partitioned by levodopa dose, medication administration frequency, and total levodopa equivalent daily dose—with the PKG providing similar symptomatic assessments to physician MDS-UPDRS-III scores. A random forest classifier trained on demographic information, MDS-UPDRS-III scores, and PKG time-series data was able to accurately classify subjects of the two most demographically similar clusters with an accuracy of 86.9%, an F1 score of 90.7%, and an AUC of 0.871. A model that relied solely on demographic information and PKG time-series data provided the next best performance with an accuracy of 83.8%, an F1 score of 88.5%, and an AUC of 0.831, hence further enabling fully remote assessments. These computational methods demonstrate the feasibility of using sensor-based data to cluster patients based on their medication responses with further potential to assist with medication recommendations.

59 BASIC BIOLOGICAL SCIENCES↗
NASA NTRS1974

Skylab medical operational support

To support the medical research and the maintenance of crew health during the three Skylab missions, a medical operational support team was organized. The functions of this team ranged from medical data management to medical systems engineering monitoring during the flights. The capability to expand preflight and postflight medical research and analysis was supplied through the use of the Skylab mobile laboratories. These mobile laboratories were not only capable of being transported to the recovery ship for postflight use, but also served as a preflight test area for gathering crewman baseline data. The laboratories contained experiment hardware identical to that of the flight orbital workshop and a laboratory diagnostic facility that duplicated many of the capabilities of ground-based clinical laboratories.

Primeaux, G. R.↗
NASA NTRS1974

Medical results of the Skylab program

The Skylab food system, waste management system, operational bioinstrumentation, personal hygiene provisions, in-flight medical support system, and the cardiovascular counterpressure garment worn during reentry are described. The medical experiments program provided scientific data and also served as the basis for real-time decisions on flight duration. Premission support, in-flight operational support, and postflight medical activities are surveyed. Measures devised to deal with possible food spoilage, medical instrument damage, and toxic atmosphere caused by the initial failures on the Orbital Workshop (OWS) are discussed. The major medical experiments performed in flight allowed the study of physiological changes as a function of exposure to weightless flight. The experiments included studies of the cardiovascular system, musculoskeletal and fluid/electrolyte balance, sleep, blood, vestibular system, and time and motion studies.

Johnston, R. S.↗
NASA NTRS1981

Emergency Medical Service (EMS): Rotorcraft Technology Workshop

A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

Bauchspies, J. S.↗
NASA NTRS1991

Shuttle Orbiter medical system equipment/supplies evaluation

The effectivity was evaluated in zero gravity of several medical equipment and supply items flown in the Shuttle Orbiter Medical System (SOMS). Several procedures listed in Medical Operations Medical Checklist, JSC 1732 were also evaluated. Several items were drawn out of the kits and tested on the KC-135. In two different flights, the following elements were examined: (1) measuring IV flow (drip chamber, one way flow valve, and air/fluid separator); (2) chemstrip protocol for urine analysis in zero-gravity; and (3) tamper resistant seals for injectable medications.

Maidlow, Kristin↗
NASA NTRS1992

Review of performance, medical, and operational data on pilot aging issues

An extensive review of the literature and studies relating to performance, medical, operational, and legal data regarding pilot aging issues was performed in order to determine what evidence there is, if any, to support mandatory pilot retirement. Popular misconceptions about aging, including the failure to distinguish between the normal aging process and disease processes that occur more frequently in older individuals, continue to contribute to much of the misunderstanding and controversy that surround this issue. Results: Review of medical data related to the pilot aging issue indicate that recent improvement in medical diagnostics and treatment technology have made it possible to identify to a high degree individuals who are at risk for developing sudden incapacitating illness and for treating those with disqualifying medical conditions. Performance studies revealed that after controlling for the presence of disease states, older pilots are able to perform as well as younger pilots on many performance tasks. Review of accident data showed that older, healthy pilots do not have higher accident rates than younger pilots, and indeeed, evidence suggests that older pilots have an advantage in the cockpit due to higher experience levels. The Man-Machine-Mission-Environment interface of factors can be managed through structured, supervised, and enhanced operations, maintenance, flight reviews, and safety procedures in order to ensure safe and productive operations by reducing the margin of error and by increasing the margin of safety. Conclusions: There is no evidence indicating any specific age as an arbitrary cut-off point for pilots to perform their fight duties. A combination of regular medical screening, performance evaluation, enhanced operational maintenance, and safety procedures can most effectively ensure a safe pilot population than can a mandatory retirement policy based on arbitrary age restrictions.

Stoklosa, J. H.↗
NASA NTRS1994

Expert Witness: A system for developing expert medical testimony

Expert Witness in an expert system designed to assist attorneys and medical experts in determining the merit of medical malpractice claims in the area of obstetrics. It substitutes the time of the medical expert with the time of a paralegal assistant guided by the expert system during the initial investigation of the medical records and patient interviews. The product of the system is a narrative transcript containing important data, immediate conclusions from the data, and overall conclusions of the case that the attorney and medical expert use to make decisions about whether and how to proceed with the case. The transcript may also contain directives for gathering additional information needed for the case. The system is a modified heuristic classifier and is implemented using over 600 CLIPS rules together with a C-based user interface. The data abstraction and solution refinement are implemented directly using forward chaining production and matching. The use of CLIPS and C is essential to delivering a system that runs on a generic PC platform. The direct implementation in CLIPS together with locality of inference ensures that the system will scale gracefully. Two years of use has revealed no errors in the reasoning.

Lewandowski, Raymond↗
NASA NTRS1999

Medical Operation KC-135 Familiarization Flight

As new personnel join the Medical Operations Branch, it is critical that they understand the effects of microgravity on medical procedures, hardware, and supplies. The familiarization flight provided new personnel with a better understanding of the effects of microgravity on (1) medical procedures, (2) patient and rescuer restraint, (3) medical fluids, and (4) medical training for space flight. The flight process also provided experience in flight proposal preparation, flight test plan preparation and execution, and final report preparation. In addition, first time flyers gained insight on their performance level in microgravity for future flights.

Dawson, Chris↗
NASA NTRS1992

Field-testing the new DECtalk PC system for medical applications

Synthesized human speech has now reached a new level of performance. With the introduction of DEC's new DECtalk PC, the small system developer will have a very powerful tool for creative design. It has been our privilege to be involved in the beta-testing of this new device and to add a medical dictionary which covers a wide range of medical terminology. With the inherent board level understanding of speech synthesis and the medical dictionary, it is now possible to provide full digital speech output for all medical files and terms. The application of these tools will cover a wide range of options for the future and allow a new dimension in dealing with the complex user interface experienced in medical practice.

NASA Discipline Data Analysis↗
NASA NTRS2005

Contingency Operations Support to NASA Johnson Space Center Medical Operations Division

The Wyle Laboratories Contingency Operations Group provides support to the NASA Johnson Space Center (JSC) Medical Operations Division in the event of a space flight vehicle accident or JSC mishap. Support includes development of Emergency Medical System (EMS) requirements, procedures, training briefings and real-time support of mishap investigations. The Contingency Operations Group is compliant with NASA documentation that provides guidance in these areas and maintains contact with the United States Department of Defense (DOD) to remain current on military plans to support NASA. The contingency group also participates in Space Operations Medical Support Training Courses (SOMSTC) and represents the NASA JSC Medical Operations Division at contingency exercises conducted worldwide by the DOD or NASA. The events of September 11, 2001 have changed how this country prepares and protects itself from possible terrorist attacks on high-profile targets. As a result, JSC is now considered a high-profile target and thus, must prepare for and develop a response to a Weapons of Mass Destruction (WMD) incident. The Wyle Laboratories Contingency Operations Group supports this plan, specifically the medical response, by providing expertise and manpower.

Stepaniak, Philip↗
NASA NTRS2006

Haughton-Mars Project (HMP)/NASA 2006 Lunar Medical Contingency Simulation: An Overview

Medical requirements are currently being developed for NASA's space exploration program. Lunar surface operations for crews returning to the moon will be performed on a daily basis to conduct scientific research and construct a lunar habitat. Inherent to aggressive surface activities is the potential risk of injury to crew members. To develop an evidence-base for handling medical contingencies on the lunar surface, a simulation project was conducted using the moon-Mars analog environment at Devon Island, Nunavut, high Canadian Arctic. A review of the Apollo lunar surface activities and personal communications with Apollo lunar crew members provided a knowledge base of plausible scenarios that could potentially injure an astronaut during a lunar extravehicular activity. Objectives were established to 1) demonstrate stabilization, field extraction and transfer an injured crew member to the habitat and 2) evaluate audio, visual and biomedical communication capabilities with ground controllers at multiple mission control centers. The simulation project s objectives were achieved. Among these objectives were 1) extracting a crew member from a sloped terrain by a two-member team in a 1-g analog environment, 2) establishing real-time communication to multiple space centers, 3) providing biomedical data to flight controllers and crew members, and 4) establishing a medical diagnosis and treatment plan from a remote site. The simulation project provided evidence for the types of equipment and methods needed for planetary space exploration. During the project, the crew members were confronted with a number of unexpected scenarios including environmental, communications, EVA suit, and navigation challenges. These trials provided insight into the challenges of carrying out a medical contingency in an austere environment. The knowledge gained from completing the objectives of this project will be incorporated into the exploration medical requirements involving an incapacited astronaut on the lunar surface.

Scheuring, R. A.↗
NASA NTRS2008

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

Niederhaus, Charles E.↗
NASA NTRS2009

SPACE MEDICINE and Medical Operations Overview

This presentation is an overview of the function of the work of the Space Medicine & Health Care Systems Office. The objective of the medical operations is to ensure the health, safety and well being of the astronaut corps and ground support team during all phases of space flight. There are many issues that impact the health of the astronauts. Some of them are physiological, and others relate to behavior, psychological issues and issues of the environment of space itself. Reviews of the medical events that have affected both Russian, and Americans while in space are included. Some views of shuttle liftoff, and ascent, the medical training aboard NASA's KC-135 and training in weightlessness, the Shuttle Orbiter Medical system (SOMS), and some of the medical equipment are included. Also included are a graphs showing Fluid loading countermeasures, and vertical pursuit tracking with head and eye. The final views are representations of the future crew exploration vehicle (CEV) approaching the International Space Station, and the moon, and a series of perspective representations of the earth in comparison to the other planets and the Sun, the Sun in relation to other stars, and a view of where in the galaxy the Sun is.

Dervay, Joe↗
NASA NTRS2009

The Skylab Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions

From May of 1973 to February of 1974, the National Aeronautics and Space Administration conducted a series of three manned missions to the Skylab space station, a voluminous vehicle largely descendant of Apollo hardware, and America s first space station. The crewmembers of these three manned missions spent record breaking durations of time in microgravity (28 days, 59 days and 84 days, respectively) and gave the U.S. space program its first experiences with long-duration space flight. The program overcame a number of obstacles (including a significant crippling of the Skylab vehicle) to conduct a lauded scientific program that encompassed life sciences, astronomy, solar physics, materials sciences and Earth observation. Skylab has more to offer than the results of its scientific efforts. The operations conducted by the Skylab crews and ground personnel represent a rich legacy of operational experience. As we plan for our return to the moon and the subsequent manned exploration of Mars, it is essential to utilize the experiences and insights of those involved in previous programs. Skylab and SMEAT (Skylab Medical Experiments Altitude Test) personnel have unique insight into operations being planned for the Constellation Program, such as umbilical extra-vehicular activity and water landing/recovery of long-duration crewmembers. Skylab was also well known for its habitability and extensive medical suite; topics which deserve further reflection as we prepare for lunar habitation and missions beyond Earth s immediate sphere of influence. The Skylab Medical Operations Summit was held in January 2008. Crewmembers and medical personnel from the Skylab missions and SMEAT were invited to participate in a two day summit with representatives from the Constellation Program medical operations community. The purpose of the summit was to discuss issues pertinent to future Constellation operations. The purpose of this document is to formally present the recommendations of the Skylab and SMEAT participants.

Polk, James D.↗
NASA NTRS2010

Optimizing Medical Kits for Space Flight

The Integrated Medical Model (IMM) uses Monte Carlo methodologies to predict the occurrence of medical events, their mitigation, and the resources required during space flight. The model includes two modules that utilize output from a single model simulation to identify an optimized medical kit for a specified mission scenario. This poster describes two flexible optimization routines built into SAS 9.1. The first routine utilizes a systematic process of elimination to maximize (or minimize) outcomes subject to attribute constraints. The second routine uses a search and mutate approach to minimize medical kit attributes given a set of outcome constraints. There are currently 273 unique resources identified that are used to treat at least one of 83 medical conditions currently in the model.

Minard, Charles G.↗
NASA NTRS2010

NASA Medical Response to Human Spacecraft Accidents

Manned space flight is risky business. Accidents have occurred and may occur in the future. NASA's manned space flight programs, with all their successes, have had three fatal accidents, one at the launch pad and two in flight. The Apollo fire and the Challenger and Columbia accidents resulted in a loss of seventeen crewmembers. Russia's manned space flight programs have had three fatal accidents, one ground-based and two in flight. These accidents resulted in the loss of five crewmembers. Additionally, manned spacecraft have encountered numerous close calls with potential for disaster. The NASA Johnson Space Center Flight Safety Office has documented more than 70 spacecraft incidents, many of which could have become serious accidents. At the Johnson Space Center (JSC), medical contingency personnel are assigned to a Mishap Investigation Team. The team deploys to the accident site to gather and preserve evidence for the Accident Investigation Board. The JSC Medical Operations Branch has developed a flight surgeon accident response training class to capture the lessons learned from the Columbia accident. This presentation will address the NASA Mishap Investigation Team's medical objectives, planned response, and potential issues that could arise subsequent to a manned spacecraft accident. Educational Objectives are to understand the medical objectives and issues confronting the Mishap Investigation Team medical personnel subsequent to a human space flight accident.

Patlach, Robert↗