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Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. Crew members operating independently during long duration space exploration missions will require a clinical decision support system (CDSS) to increase autonomy by augmenting their knowledge, skills and abilities in different scenarios. Significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities are needed to increase crew autonomy and self-reliance in decision making and task performance. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. Clinical decision support (CDS) presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. A comprehensive crew health and performance CDSS is required to augment crew capability and will be used in different scenarios for several reasons. In general, the CDSS’s role is to assist the crew in prevention, detection, diagnosis and treatment of crew health and performance related conditions that may arise in exploration spaceflight. For example, CDSS would assist a high acuity scenario such as a heart attack by supplying clear instructions, vital signs and treatment reminders. A lower severity scenario such as kidney stone risk could interface to vehicle systems and display more complex predictive data during a diagnosis. A CDSS needs to contribute to successful missions by maintaining a high performing crew who can potentially exhibit countless medical conditions related to derangements from the space environment (sleep, cognition, nutrition and exercise) as well as conditions intrinsic to humans anywhere. While supporting the crew’s ability to make sound clinical decisions is desirable in any mission, it is essential for exploration missions with significant communication delays, no evacuation capability, and extended exposure to the flight environment. Such missions correspond with medical Level of Care V (LOC V), the highest level specified in NASA-STD-3001. The project focuses on CDS implementation research to derive requirements for LOC V, where the need for increased autonomy results in new practices and the inclusion of non-clinical data, such as vehicle environmental measures and physical exercise results, from other human and vehicle domains and advanced analytics. The CDS project describes how the CDSS is intended to be used by defining concepts of operations (ConOps). The process to derive ConOps focuses on increased autonomy that reduces the likelihood and consequences of accepted medical conditions. These crew health and performance inputs are grouped by common datasets and analysis models. Use cases are derived to research new clinical scenarios, architectural development and workflows. Implementation research is conducted with protypes to inform assumptions and derive requirements. The project also establishes how externally developed analysis and approaches can be added to expand a clinical decision support system and thus highlight how a comprehensive system can be globally developed with collaborators. This presentation will cover example scenarios from the CDS ConOps and the method to derive them. One example scenario will be CDSS alerting an increased kidney stone risk during a mission, with diagnosis and treatment options provided during the intervention.

clinical decision support↗
DOE OSTI2026

Multi‐Model Ensembles in Ecosystem Modeling: Challenges and Best Practices for Decision‐Making

Ecosystem models are increasingly central to the decision-making for environmental policy, conservation planning, and climate-related investments. Yet, the growing reliance on Multi-Model Ensembles (MMEs) of ecosystem models by practitioners and policymakers, sometimes under tight timelines and imperfect information, has frequently outpaced the scientific rigor required to ensure ensemble reliability. Here, MMEs refer to approaches that combine targeted predictions from multiple models with the expectation of improving robustness and quantifying predictive uncertainty. Poorly designed MMEs may create a false sense of confidence and lead to suboptimal policy and market decisions. This perspective argues that robust decision-making-relevant MMEs must be grounded on two pillars: (1) rigorous Model Intercomparison Projects (MIPs), which identify inter-model agreement and disagreement, characterize model uncertainties, and evaluate robustness with observationally based benchmarks—MIPs' diagnostic evaluation is so critical that it must be needed to drive MME's decision in model selection and weighting, especially when only a limited number of models available; and (2) co-design by both stakeholders and scientists to ensure that scenarios, metrics and uncertainty requirements provide decision-relevant information. Building upon the past success and lessons from the existing MIPs-MMEs efforts (e.g., climate/Earth system/crop), we derived the theoretical basis for MMEs, addressed their specific challenges in ecosystem modeling, and highlighted proper consideration of model numbers and diversity, risk of model inter-dependence, effective calibration of model parameters, possible overdue of some ecosystem model development, critical roles of open benchmark data across a wide range of conditions, and suggested use of Artificial Intelligence to support MIPs-MMEs. We highlighted the under-recognized opportunity for MIPs and MMEs to drive scientific progress and innovation through identifying better performing models, systematic benchmarking, feedback loops, and targeted model improvement. By following actionable best practice guidelines, MMEs can evolve from ad hoc aggregation of models into a trusted backbone of environmental policy and decision-making.

ecosystem modeling↗
DOE OSTI2026

Decision Support System

Forest-based value chains involve decisions that begin at the landscape level and extend through processing, product manufacturing, and end-use markets. However, these decisions are often made independently across sectors, with limited visibility into how upstream resource conditions, incentives, and land management choices influence downstream production systems. In forested regions of the United States, wildfire risk, fragmented ownership, and uncertain markets for low-value residues complicate efforts to align extraction, processing, and utilization decisions. Without tools that link these stages, stakeholders may overlook opportunities to improve resource utilization or inadvertently shift impacts elsewhere in the value chain. This repository introduces a decision support system (DSS) that applies a system-impact-analysis approach to forest biomass residues and co-products. The framework integrates forest inventory data, geospatial resource assessments, and economic modeling to evaluate how biomass extraction decisions influence downstream product pathways. By linking regional feedstock avail- ability with market incentives and processing options—such as fuels, wood products, or soil amendments like biochar—the tool allows decision-makers to compare value chain outcomes across multiple utilization strategies.

Davis, Maggie [Oak Ridge National Laboratory (ORNL↗
DOE OSTI2024

UPGRADE-E: Understanding Patterns Guiding Residential Adoption and Decisions about Energy Efficiency

This work represents the largest and most comprehensive dataset to-date of responses surveyed from U.S. residents regarding home modifications and energy-related decision-making, including both objective measures describing the occupants and their homes and subjective measures describing the more unpredictable human factors behind residential decision-making. First, to develop the survey, we interviewed 121 individual decision-makers within their households regarding planned or completed projects. We used the insights of these interviews to design a survey that was distributed to 10,000 households across the U.S. The overarching topics approached in the survey include descriptive information about the respondent, their household, their home, home modifications they have made, and the human cognition-based contextual factors involved in home projects and decision-making, such as preferences, motivations, barriers, and information sources. The processed data from the survey was compiled into a dataset entitled UPGRADE-E: Understanding Patterns Guiding Residential Adoption and Decisions about Energy Efficiency and represents the basis for the analyses included in this paper. The dataset represents a rich repository of home energy technology and modification decision-making results, the largest of its kind to-date. The abundance of contextual considerations within this dataset provides a robust resource for continual analysis, with possibilities for considering cross-cuts of data from a variety of perspectives.

Fuentes, Tracy L↗
NASA NTRS1970

Analysis of a Decision-Directed Receiver with Unknown Priors

A decision-directed receiver (DDR) uses previous outputs (decisions) to estimate unknown parameters and, on the basis of these estimates, modifies the detector structure for subsequent decisions. Although the DDR is less complex to instrument than other adaptive schemes, inherent in the decision-directed approach is the possibility of a runaway. This occurs when the detector commits a sequence of decision errors resulting in a degradation of parameter estimates, which, in turn, results in a further deterioration of detector performance. Because of the dependencies introduced by the learning process, runaway is difficult to analyze. In this paper, a DDR with unknown a priori probabilities is considered. The priors are estimated by the relative frequency of decisions of that event. For binary detection, it is shown that there is a positive probability of a runaway (the estimates converge to 1 or 0), which equals 1 if the signal-to-noise ratio is below a critical value. A tight bound on the probability of a runaway is obtained by approximating the learning process by a random walk with independent increments. The analysis demonstrates that a runaway is quite improbable even for moderate signal-to-noise ratios. The analysis is extended to multiple signals and to the situation where the estimates of the priors are updated continuously through exponential weighting rather than allowed to converge.

Davisson, Lee D.↗
NASA NTRS1980

Decision-problem state analysis methodology

A methodology for analyzing a decision-problem state is presented. The methodology is based on the analysis of an incident in terms of the set of decision-problem conditions encountered. By decomposing the events that preceded an unwanted outcome, such as an accident, into the set of decision-problem conditions that were resolved, a more comprehensive understanding is possible. All human-error accidents are not caused by faulty decision-problem resolutions, but it appears to be one of the major areas of accidents cited in the literature. A three-phase methodology is presented which accommodates a wide spectrum of events. It allows for a systems content analysis of the available data to establish: (1) the resolutions made, (2) alternatives not considered, (3) resolutions missed, and (4) possible conditions not considered. The product is a map of the decision-problem conditions that were encountered as well as a projected, assumed set of conditions that should have been considered. The application of this methodology introduces a systematic approach to decomposing the events that transpired prior to the accident. The initial emphasis is on decision and problem resolution. The technique allows for a standardized method of accident into a scenario which may used for review or the development of a training simulation.

Dieterly, D. L.↗
NASA NTRS1980

An automated approach to the design of decision tree classifiers

The classification of large dimensional data sets arising from the merging of remote sensing data with more traditional forms of ancillary data is considered. Decision tree classification, a popular approach to the problem, is characterized by the property that samples are subjected to a sequence of decision rules before they are assigned to a unique class. An automated technique for effective decision tree design which relies only on apriori statistics is presented. This procedure utilizes a set of two dimensional canonical transforms and Bayes table look-up decision rules. An optimal design at each node is derived based on the associated decision table. A procedure for computing the global probability of correct classfication is also provided. An example is given in which class statistics obtained from an actual LANDSAT scene are used as input to the program. The resulting decision tree design has an associated probability of correct classification of .76 compared to the theoretically optimum .79 probability of correct classification associated with a full dimensional Bayes classifier. Recommendations for future research are included.

Argentiero, P.↗
NASA NTRS1980

A framework for automated decision making and problem solving

Problems can be subdivided into two main categories: well structured problems and ill structured problems. The first require routine repetitive decisions which are generally amenable to programmable decision processes. The second require novel nonprogrammable decision processes. The decision making processes can be subdivided into those representative of those done by humans and those done by machine. Many of such decision processes require a combination of humans d machines. Automated decision making and problem solving technologies are expected to have their greatest potential impact in the space program.

Heer, E.↗
NASA NTRS1982

An automated approach to the design of decision tree classifiers

An automated technique is presented for designing effective decision tree classifiers predicated only on a priori class statistics. The procedure relies on linear feature extractions and Bayes table look-up decision rules. Associated error matrices are computed and utilized to provide an optimal design of the decision tree at each so-called 'node'. A by-product of this procedure is a simple algorithm for computing the global probability of correct classification assuming the statistical independence of the decision rules. Attention is given to a more precise definition of decision tree classification, the mathematical details on the technique for automated decision tree design, and an example of a simple application of the procedure using class statistics acquired from an actual Landsat scene.

Argentiero, P.↗
NASA NTRS1989

Methods and decision making on a Mars rover for identification of fossils

A system for automated fusion and interpretation of image data from multiple sensors, including multispectral data from an imaging spectrometer is being developed. Classical artificial intelligence techniques and artificial neural networks are employed to make real time decision based on current input and known scientific goals. Emphasis is placed on identifying minerals which could indicate past life activity or an environment supportive of life. Multispectral data can be used for geological analysis because different minerals have characteristic spectral reflectance in the visible and near infrared range. Classification of each spectrum into a broad class, based on overall spectral shape and locations of absorption bands is possible in real time using artificial neural networks. The goal of the system is twofold: multisensor and multispectral data must be interpreted in real time so that potentially interesting sites can be flagged and investigated in more detail while the rover is near those sites; and the sensed data must be reduced to the most compact form possible without loss of crucial information. Autonomous decision making will allow a rover to achieve maximum scientific benefit from a mission. Both a classical rule based approach and a decision neural network for making real time choices are being considered. Neural nets may work well for adaptive decision making. A neural net can be trained to work in two steps. First, the actual input state is mapped to the closest of a number of memorized states. After weighing the importance of various input parameters, the net produces an output decision based on the matched memory state. Real time, autonomous image data analysis and decision making capabilities are required for achieving maximum scientific benefit from a rover mission. The system under development will enhance the chances of identifying fossils or environments capable of supporting life on Mars

Eberlein, Susan↗
NASA NTRS1990

Acquisition and production of skilled behavior in dynamic decision-making tasks

Ongoing research investigating perceptual and contextual influences on skilled human performance in dynamic decision making environments is discussed. The research is motivated by two general classes of findings in recent decision making research. First, many studies suggest that the concrete context in which a task is presented has strong influences on the psychological processes used to perform the task and on subsequent performance. Second, studies of skilled behavior in a wide variety of task environments typically implicate the perceptual system as an important contributor to decision-making performance, either in its role as a mediator between the current decision context and stored knowledge, or as a mechanism capable of directly initiating activity through the development of a 'trained eye.' Both contextual and perceptual influences place limits on the ability of traditional utility-theoretic accounts of decision-making to guide display design, as variance in behavior due to contextual factors or the development of a perceptual skill is left unexplained. The author outlines a framework in which to view questions of perceptual and contextual influences on behavior and describe an experimental task and analysis technique which will be used to diagnose the possible role of perception in skilled decision making performance.

Kirlik, Alex↗
NASA NTRS1992

Decision boundary feature extraction for neural networks

We propose a new feature extraction method for neural networks. The method is based on the recently published decision boundary feature extraction algorithm. It has been shown that all the necessary features for classification can be extracted from the decision boundary. To apply the decision boundary feature extraction method, we first define the decision boundary in neural networks. Next, we propose a procedure for extracting all the necessary features for classification from the decision boundary. The proposed algorithm preserves the characteristics of neural networks, which can define arbitrary decision boundary. Experiments show promising results.

Lee, Chulhee↗
NASA NTRS1993

Modelling decision-making by pilots

Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).

Patrick, Nicholas J. M.↗
NASA NTRS1994

New approaches for real time decision support systems

NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

Hair, D. Charles↗
NASA NTRS1994

Stochastic decision analysis

Small space flight project design at NASA Langley Research Center goes through a multi-phase process from preliminary analysis to flight operations. The process insures that each system achieves its technical objectives with demonstrated quality and within planned budgets and schedules. A key technical component of early phases is decision analysis, which is a structure procedure for determining the best of a number of feasible concepts based upon project objectives. Feasible system concepts are generated by the designers and analyzed for schedule, cost, risk, and technical measures. Each performance measure value is normalized between the best and worst values and a weighted average score of all measures is calculated for each concept. The concept(s) with the highest scores are retained, while others are eliminated from further analysis. This project automated and enhanced the decision analysis process. Automation of the decision analysis process was done by creating a user-friendly, menu-driven, spreadsheet macro based decision analysis software program. The program contains data entry dialog boxes, automated data and output report generation, and automated output chart generation. The enhancements to the decision analysis process permit stochastic data entry and analysis. Rather than enter single measure values, the designers enter the range and most likely value for each measure and concept. The data can be entered at the system or subsystem level. System level data can be calculated as either sum, maximum, or product functions of the subsystem data. For each concept, the probability distributions are approximated for each measure and the total score for each concept as either constant, triangular, normal, or log-normal distributions. Based on these distributions, formulas are derived for the probability that the concept meets any given constraint, the probability that the concept meets all constraints, and the probability that the concept is within a given amount of the best score. Formulas are also derived for the probability that one concept's total score is within a given amount of a second concept's total score. These probabilistic calculations provide more realistic data entry and output information for designers, enabling designers to better determine which concepts to eliminate and which concepts to retain at the decision points of each design phase.

Lacksonen, Thomas A.↗
NASA NTRS1996

Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

Most decisions made in the cockpit are related to safety, and have therefore been proceduralized in order to reduce risk. There are very few which are made on the basis of a value metric such as economic cost. One which can be shown to be value based, however, is the selection of a flight profile. Fuel consumption and flight time both have a substantial effect on aircraft operating cost, but they cannot be minimized simultaneously. In addition, winds, turbulence, and performance x,ary widely with altitude and time. These factors make it important and difficult for pilots to (a) evaluate the outcomes associated with a particular trajectory before it is flown and (b) decide among possible trajectories. The two elements of this problem considered here are (1) determining, what constitutes optimality, and (2) finding optimal trajectories. Pilots and dispatchers from major U.S. airlines were surveyed to determine which attributes of the outcome of a flight they considered the most important. Avoiding turbulence-for passenger comfort topped the list of items which were not safety related. Pilots' decision making about the selection of flight profile on the basis of flight time, fuel burn, and exposure to turbulence was then observed. Of the several behavioral and prescriptive decision models invoked to explain the pilots' choices, utility maximization is shown to best reproduce the pilots' decisions. After considering more traditional methods for optimizing trajectories, a novel method is developed using a genetic algorithm (GA) operating on a discrete representation of the trajectory search space. The representation is a sequence of command altitudes, and was chosen to be compatible with the constraints imposed by Air Traffic Control, and with the training given to pilots. Since trajectory evaluation for the GA is performed holistically, a wide class of objective functions can be optimized easily. Also, using the GA it is possible to compare the costs associated with different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimility with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider un-modelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

Patrick, Nicholas J. M.↗
NASA NTRS1996

Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

Most decisions made in the cockpit are related to safety, and have therefore been proceduralized in order to reduce risk. There are very few which are made on the basis of a value metric such as economic cost. One which can be shown to be value based, however, is the selection of a flight profile. Fuel consumption and flight time both have a substantial effect on aircraft operating cost, but they cannot be minimized simultaneously. In addition, winds, turbulence, and performance vary widely with altitude and time. These factors make it important and difficult for pilots to (a) evaluate the outcomes associated with a particular trajectory before it is flown and (b) decide among possible trajectories. The two elements of this problem considered here are: (1) determining what constitutes optimality, and (2) finding optimal trajectories. Pilots and dispatchers from major u.s. airlines were surveyed to determine which attributes of the outcome of a flight they considered the most important. Avoiding turbulence-for passenger comfort-topped the list of items which were not safety related. Pilots' decision making about the selection of flight profile on the basis of flight time, fuel burn, and exposure to turbulence was then observed. Of the several behavioral and prescriptive decision models invoked to explain the pilots' choices, utility maximization is shown to best reproduce the pilots' decisions. After considering more traditional methods for optimizing trajectories, a novel method is developed using a genetic algorithm (GA) operating on a discrete representation of the trajectory search space. The representation is a sequence of command altitudes, and was chosen to be compatible with the constraints imposed by Air Traffic Control, and with the training given to pilots. Since trajectory evaluation for the GA is performed holistically, a wide class of objective functions can be optimized easily. Also, using the GA it is possible to compare the costs associated with different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimality with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider unmodelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

Patrick, Nicholas J. M.↗
NASA NTRS1998

Weather Avoidance Using Route Optimization as a Decision Aid: An AWIN Topical Study

The aviation community is faced with reducing the fatal aircraft accident rate by 80 percent within 10 years. This must be achieved even with ever increasing, traffic and a changing National Airspace System. This is not just an altruistic goal, but a real necessity, if our growing level of commerce is to continue. Honeywell Technology Center's topical study, "Weather Avoidance Using Route Optimization as a Decision Aid", addresses these pressing needs. The goal of this program is to use route optimization and user interface technologies to develop a prototype decision aid for dispatchers and pilots. This decision aid will suggest possible diversions through single or multiple weather hazards and present weather information with a human-centered design. At the conclusion of the program, we will have a laptop prototype decision aid that will be used to demonstrate concepts to industry for integration into commercialized products for dispatchers and/or pilots. With weather a factor in 30% of aircraft accidents, our program will prevent accidents by strategically avoiding weather hazards in flight. By supplying more relevant weather information in a human-centered format along with the tools to generate flight plans around weather, aircraft exposure to weather hazards can be reduced. Our program directly addresses the NASA's five year investment areas of Strategic Weather Information and Weather Operations (simulation/hazard characterization and crew/dispatch/ATChazard monitoring, display, and decision support) (NASA Aeronautics Safety Investment Strategy: Weather Investment Recommendations, April 15, 1997). This program is comprised of two phases, Phase I concluded December 31, 1998. This first phase defined weather data requirements, lateral routing algorithms, an conceptual displays for a user-centered design. Phase II runs from January 1999 through September 1999. The second phase integrates vertical routing into the lateral optimizer and combines the user interface into a prototype software testbed. Phase II concludes with a dispatcher and pilot evaluation of the route optimizer decision aid. This document describes work completed in Phase I in contract with NASA Langley August 1998 - December 1998. This report includes: (1) Discuss how weather hazards were identified in partnership with experts, and how weather hazards were prioritized; (2) Static representations of display layouts for integrated planning function (3) Cost function for the 2D route optimizer; (4) Discussion of the method for obtaining, access to raw data of, and the results of the flight deck user information requirements definition; (5) Itemized display format requirements identified for representing weather hazards in a route planning aid.

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