Results for “DECISION” — Page 6

NASA NTRSDate not supplied

Objective Structured Clinical Evaluation (OSCE) of an Artificial Intelligence (AI) Clinical Decision Support System (CDSS) Tool

BACKGROUND Objective Structured Clinical Evaluations (OSCEs) have long been established as a robust methodology for summative assessment of clinical skills and decision-making during medical education. The recent integration of Artificial Intelligence (AI) into clinical decision-making processes has prompted the need for novel evaluation frameworks to assess the efficacy and reliability of AI clinical decision support system (CDSS) tools. This abstract outlines the process of quantitatively evaluating a novel CDSS (“Doc in a Box” Google 2024) trained on curated medical spaceflight data in the psychomotor domain as it interfaces with a human volunteer acting as the crew medical officer (CMO). PURPOSE The AI CDSS under review was developed as part of the Lunar Command and Control Interoperability (LuCCI) project, which is intended to address a gap in how Lunar Surface Systems (LSS) would interoperate across multiple programs, commercial partners, and international partners. The project objective is to define, prototype, integrate, and evaluate an interoperable lunar command, control, data, and software reference architecture to enable autonomy and informatics capability through common standards across LSS. A multi-modal AI-based CDSS compatible with Federated LSS will assist clinicians in diagnosing and managing complex medical conditions by providing evidence-based recommendations through predictive analytics. Given the critical role of decision-support as NASA continues to evolve its Earth-independent medical operations (EIMO), it is imperative to ensure that such AI tools perform reliably and align with clinical standards during progressive lunar and Martian exploration class missions. METHODS The OSCE framework, traditionally used for evaluating human clinicians, was adapted to assess the AI tool's decision-making capabilities in simulated clinical scenarios. In this adapted OSCE, the AI CDSS was tested across a series of structured clinical scenarios designed to mimic real-life spaceflight patient cases. These scenarios included a range of conditions and complexities, allowing for comprehensive assessment of the tool's performance. Key evaluation metrics included accuracy of diagnosis, timeliness of decision-making, and appropriate recommendations for therapies. The OSCE was scored by human physician evaluators who assessed the AI's recommendations in comparison with expert clinicians' medical decision making to ensure alignment with best practices and the standard of care. RESULTS Preliminary results indicate that the AI CDSS demonstrated high accuracy in diagnostic recommendations and decision support across various scenarios. However, certain limitations were noted, such as occasional discrepancies in handling complex or nuanced cases that required a more contextual understanding. Additionally, the tool scored higher on the diagnostic portion of the rubric, with lower scores in the therapeutic recommendations. These findings highlight the importance of continuous refinement and validation of AI tools through rigorous evaluation frameworks like the OSCE. The adaptation of OSCEs for AI tools presents several advantages, including a structured and reproducible approach to evaluation, the ability to test AI systems in diverse clinical scenarios, and the opportunity to benchmark AI performance against established clinical standards to permit charting of future progress as aerospace medicine evolves as a discipline. Remaining challenges include ensuring that these evaluations capture the full spectrum of clinical decision-making scenarios that will be confronted by CMOs during missions and adequately reflecting real-world variability of the austere spaceflight environment. CONCLUSION Employing OSCEs to evaluate AI clinical decision support tools offers a promising approach to validating their clinical utility and efficacy. This methodology not only provides insights into the tool's performance but also fosters ongoing improvement and alignment with standard of care practices. Future research should focus on refining these evaluation processes and addressing limitations to enhance the integration of AI tools in clinical spaceflight settings. REFERENCES Scott S, Hearns V, Barker MA. Testing Clinical Skills: A Look at the OSCE and USMLE Clinical Skills Exams. S D Med. 2019 Oct;72(10):451-453. Majumder MAA, Kumar A, Krishnamurthy K, Ojeh N, Adams OP, Sa B. An evaluative study of objective structured clinical examination (OSCE): students and examiners perspectives. Adv Med Educ Pract. 2019 Jun 5;10:387-397. Karam VY, Park YS, Tekian A, Youssef N. Evaluating the validity evidence of an OSCE: results from a new medical school. BMC Med Educ. 2018 Dec 20;18(1):313.

Ariana M Nelson↗

DOE OSTI2017

Decision Analyses Related to Groundwater Remediation - 17051

Traditional decision analyses of groundwater remediation scenarios frequently fail because the probability of adverse, unanticipated events occurring is often high. This is driven by many factors including that (1) the models developed to represent the flow and transport in contaminated aquifers are typically simpler than reality and do not account for all the important governing processes, (2) probability distributions are assigned to critical performance parameters (such as model inputs or characteristics of the engineered remediation systems) even though some of these parameters might be unknown or not be very well constrained. However, there is a novel decision analysis methodology and a computational tool based on Bayesian Information-Gap Decision Theory (BIG-DT) that are designed to mitigate the shortcomings of the models and probabilistic decision analyses by leveraging a non-probabilistic decision theory -- information-gap decision theory. The new decision analysis methodology considers possible models that have not been explicitly enumerated and does not require us to commit to a particular probability distribution for model and remediation-design parameters. Both the set of possible models and the set of possible probability distributions grow as the degree of uncertainty increases. The fundamental question that BIG-DT asks is 'How large can these sets be before a particular decision results in an undesirable outcome?'. The decision that allows these sets to be the largest is considered to be the best option. In this way, BIG-DT enables robust decision-support for groundwater remediation problems. Here, we apply BIG-DT to a representative groundwater remediation scenario where different options for hydraulic containment and pump and treat are being considered. BIG-DT requires many model runs and high-performance computing resources are needed when complex models are used. We demonstrate the BIG-DT analyses on a series of synthetic problems that are designed to be consistent with real-world problems such as Los Alamos National Laboratory (LANL) contamination sites. We also discuss a general framework for how the BIG-DT analyses will be carried out at the chromium groundwater contamination site at LANL. BIG-DT is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is part of the MADS framework (http://mads.lanl.gov and http://madsjulia.github.io/Mads.jl). (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2012

Evolution of quantum-like modeling in decision making processes

The application of the mathematical formalism of quantum mechanics to model behavioral patterns in social science and economics is a novel and constantly emerging field. The aim of the so called 'quantum like' models is to model the decision making processes in a macroscopic setting, capturing the particular 'context' in which the decisions are taken. Several subsequent empirical findings proved that when making a decision people tend to violate the axioms of expected utility theory and Savage's Sure Thing principle, thus violating the law of total probability. A quantum probability formula was devised to describe more accurately the decision making processes. A next step in the development of QL-modeling in decision making was the application of Schroedinger equation to describe the evolution of people's mental states. A shortcoming of Schroedinger equation is its inability to capture dynamics of an open system; the brain of the decision maker can be regarded as such, actively interacting with the external environment. Recently the master equation, by which quantum physics describes the process of decoherence as the result of interaction of the mental state with the environmental 'bath', was introduced for modeling the human decision making. The external environment and memory can be referred to as a complex 'context' influencing the final decision outcomes. The master equation can be considered as a pioneering and promising apparatus for modeling the dynamics of decision making in different contexts.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2022

Climate-aware decision-making: lessons for electric grid infrastructure planning and operations

Abstract Climate change poses significant risks to large-scale infrastructure systems and brings considerable uncertainties that challenge historical planning approaches. Here we focus on how climate awareness might be better incorporated into planning and decision-making in the electric power sector. To do so, we consider lessons from decision science literature where researchers have specifically focused on how to make better decisions under uncertainty. We perform a three-part review: of decision science literature on best practices for decision-making under uncertainty, of industry practice documents to understand how new uncertainties may affect the types of decisions electric utilities are making today, and of literature on electricity sector planning under climate change to assess how lessons from decision science might fit into sector-specific analyses. We discuss how characterizations of uncertainty from the decision science literature might guide approaches in the electricity sector to appropriately capture climate-related uncertainties. We also distill three key ideas from the decision science literature that can be incorporated into electricity sector planning to manage these new uncertainties: robustness, adaptive planning, and multi-stakeholder engagement. We offer example recommendations for how these key ideas might be incorporated into one essential type of planning activity, capacity expansion.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2022

The modeling of risk perception in the use of structural health monitoring information for optimal maintenance decisions

This paper proposes an approach to select a maintenance strategy from a predefined set of choices considering the decision maker’s behavioral risk profile. It is assumed that the damage state is characterized by a continuous state parameter probabilistically inferred from observable sensor data. This work applies an engineering application of consequence-based decision-making incorporating the acceptable risk intensity of the decision-maker, i.e., the decision-maker’s (individual or an organization) valuation of the outcome of a decision, using a risk profile model. The utility of a decision-maker is subjective, and this paper considers the fact that different decision-makers mentally assign a different importance factor (the utility) to the seriousness or urgency to take necessary actions with the increasing intensity of structural damage. The approach herein incorporates a layer of human psychology on selecting appropriate maintenance strategies that not only depend on the posterior distribution of unmeasurable damage state but also consider the behavioral risk profile of the decision-maker. Further, the collective decision-making of an organization consisting of many individuals is also investigated. The approach is exemplified in a case study involving life cycle monitoring of a miter gate, part of a lock system enabling navigation of inland waterways.

42 ENGINEERING↗

DOE OSTI2021

Analytical Framework for Homeowner-Focused Computational Cost-Benefit Mitigation Decision Making

As a result of increasing windstorm losses in the United States over the past 50 years, a variety of residential wind hazard mitigation strategies have been recommended. Wind hazard mitigation undoubtedly reduces windstorm losses; however, little customized information is available to support the economic decision-making process for individual stakeholders, especially at the consumer level. Therefore, there is a need for decision support tools to calculate, evaluate, and present the economic benefits of mitigation over variable decision-making time horizons for unique building characteristics in specific geographical locations. This paper presents a cost-benefit computational decision-making recommendation framework that evaluates and presents the cost effectiveness of mitigation, customized based on location, years of interest, and building characteristics. The decision-making framework consists of two cores. The user-independent core and user-dependent core which consists of eight steps, divided into four subprocesses: (1) data acquisition, (2) data evaluation, (3) cost-benefit calculation, and (4) results comparison and decision making. To demonstrate the framework, a wood-framed single-family home in light suburban terrain in Golden Meadow, Louisiana, is used as a case study, considering retrofit mitigation with a $15,000 budget and a decision-making time horizon of 30 years. The case study provides six mitigation options, with cost ranging between approximately $2,000 and $15,000 and net benefit/cost ratios ranging from 2.4 to 13. Once fully implemented in a decision making information tool, the developed mitigation recommendation framework will provide valuable information that can be used by home designers, builders, owners, and other stakeholders to better understand the economic facets of wind hazard mitigation, providing critical information as part of the overall decision-making process.

Orooji, Fatemeh↗

NASA NTRS1971

A control-theory model for human decision-making

A model for human decision making is an adaptation of an optimal control model for pilot/vehicle systems. The models for decision and control both contain concepts of time delay, observation noise, optimal prediction, and optimal estimation. The decision making model was intended for situations in which the human bases his decision on his estimate of the state of a linear plant. Experiments are described for the following task situations: (a) single decision tasks, (b) two-decision tasks, and (c) simultaneous manual control and decision making. Using fixed values for model parameters, single-task and two-task decision performance can be predicted to within an accuracy of 10 percent. Agreement is less good for the simultaneous decision and control situation.

Levison, W. H.↗

NASA NTRS1990

Documenting the decision structure in software development

Current software development paradigms focus on the products of the development process. Much of the decision making process which produces these products is outside the scope of these paradigms. The Decision-Based Software Development (DBSD) paradigm views the design process as a series of interrelated decisions which involve the identification and articulation of problems, alternates, solutions and justifications. Decisions made by programmers and analysts are recorded in a project data base. Unresolved problems are also recorded and resources for their resolution are allocated by management according to the overall development strategy. This decision structure is linked to the products affected by the relevant decision and provides a process oriented view of the resulted system. Software maintenance uses this decision view of the system to understand the rationale behind the decisions affecting the part of the system to be modified. D-HyperCase, a prototype Decision-Based Hypermedia System is described and results of applying the DBSD approach during its development are presented.

Wild, J. Christian↗

NASA NTRS1993

Criteria for assessing problem solving and decision making in complex environments

Training crews to cope with unanticipated problems in high-risk, high-stress environments requires models of effective problem solving and decision making. Existing decision theories use the criteria of logical consistency and mathematical optimality to evaluate decision quality. While these approaches are useful under some circumstances, the assumptions underlying these models frequently are not met in dynamic time-pressured operational environments. Also, applying formal decision models is both labor and time intensive, a luxury often lacking in operational environments. Alternate approaches and criteria are needed. Given that operational problem solving and decision making are embedded in ongoing tasks, evaluation criteria must address the relation between those activities and satisfaction of broader task goals. Effectiveness and efficiency become relevant for judging reasoning performance in operational environments. New questions must be addressed: What is the relation between the quality of decisions and overall performance by crews engaged in critical high risk tasks? Are different strategies most effective for different types of decisions? How can various decision types be characterized? A preliminary model of decision types found in air transport environments will be described along with a preliminary performance model based on an analysis of 30 flight crews. The performance analysis examined behaviors that distinguish more and less effective crews (based on performance errors). Implications for training and system design will be discussed.

Orasanu, Judith↗

NASA NTRS2009

Using Decision Trees to Detect and Isolate Simulated Leaks in the J-2X Rocket Engine

The goal of this work was to use data-driven methods to automatically detect and isolate faults in the J-2X rocket engine. It was decided to use decision trees, since they tend to be easier to interpret than other data-driven methods. The decision tree algorithm automatically "learns" a decision tree by performing a search through the space of possible decision trees to find one that fits the training data. The particular decision tree algorithm used is known as C4.5. Simulated J-2X data from a high-fidelity simulator developed at Pratt & Whitney Rocketdyne and known as the Detailed Real-Time Model (DRTM) was used to "train" and test the decision tree. Fifty-six DRTM simulations were performed for this purpose, with different leak sizes, different leak locations, and different times of leak onset. To make the simulations as realistic as possible, they included simulated sensor noise, and included a gradual degradation in both fuel and oxidizer turbine efficiency. A decision tree was trained using 11 of these simulations, and tested using the remaining 45 simulations. In the training phase, the C4.5 algorithm was provided with labeled examples of data from nominal operation and data including leaks in each leak location. From the data, it "learned" a decision tree that can classify unseen data as having no leak or having a leak in one of the five leak locations. In the test phase, the decision tree produced very low false alarm rates and low missed detection rates on the unseen data. It had very good fault isolation rates for three of the five simulated leak locations, but it tended to confuse the remaining two locations, perhaps because a large leak at one of these two locations can look very similar to a small leak at the other location.

Schwabacher, Mark A.↗

NASA NTRS2011

The First Flight Decision for New Human Spacecraft Vehicles - A General Approach

Determining when it is safe to fly a crew on a launch vehicle/spacecraft for the first time, especially when the test flight is a part of the overall system certification process, has long been a challenge for program decision makers. The decision on first flight is ultimately the judgment of the program and agency management in conjunction with the design and operations team. To aid in this decision process, a NASA team undertook the task to develop a generic framework for evaluating whether any given program or commercial provider has sufficiently complete and balanced plans in place to allow crewmembers to safely fly on human spaceflight systems for the first time. It was the team s goal to establish a generic framework that could easily be applied to any new system, although the system design and intended mission would require specific assessment. Historical data shows that there are multiple approaches that have been successful in first flight with crew. These approaches have always been tailored to the specific system design, mission objectives, and launch environment. Because specific approaches may vary significantly between different system designs and situations, prescriptive instructions or thorough checklists cannot be provided ahead of time. There are, however, certain general approaches that should be applied in thinking through the decision for first flight. This paper addresses some of the most important factors to consider when developing a new system or evaluating an existing system for whether or not it is safe to fly humans to/from space. In the simplest terms, it is time to fly crew for the first time when it is safe to do so and the benefit of the crewed flight is greater than the residual risk. This is rarely a straight-forward decision. The paper describes the need for experience, sound judgment, close involvement of the technical and management teams, and established decision processes. In addition, the underlying level of confidence the manager has in making the decision will also be discussed. By applying the outlined thought processes and approaches to a specific design, test program and mission objectives, a project team will be better able to focus the debate and discussion on critical areas for consideration and added scrutiny -- allowing decision makers to adequately address the first crewed flight decision.

Schaible, Dawn M.↗

NASA NTRS2009

Probabilistic Risk Assessment for Decision Making During Spacecraft Operations

Decisions made during the operational phase of a space mission often have significant and immediate consequences. Without the explicit consideration of the risks involved and their representation in a solid model, it is very likely that these risks are not considered systematically in trade studies. Wrong decisions during the operational phase of a space mission can lead to immediate system failure whereas correct decisions can help recover the system even from faulty conditions. A problem of special interest is the determination of the system fault protection strategies upon the occurrence of faults within the system. Decisions regarding the fault protection strategy also heavily rely on a correct understanding of the state of the system and an integrated risk model that represents the various possible scenarios and their respective likelihoods. Probabilistic Risk Assessment (PRA) modeling is applicable to the full lifecycle of a space mission project, from concept development to preliminary design, detailed design, development and operations. The benefits and utilities of the model, however, depend on the phase of the mission for which it is used. This is because of the difference in the key strategic decisions that support each mission phase. The focus of this paper is on describing the particular methods used for PRA modeling during the operational phase of a spacecraft by gleaning insight from recently conducted case studies on two operational Mars orbiters. During operations, the key decisions relate to the commands sent to the spacecraft for any kind of diagnostics, anomaly resolution, trajectory changes, or planning. Often, faults and failures occur in the parts of the spacecraft but are contained or mitigated before they can cause serious damage. The failure behavior of the system during operations provides valuable data for updating and adjusting the related PRA models that are built primarily based on historical failure data. The PRA models, in turn, provide insight into the effect of various faults or failures on the risk and failure drivers of the system and the likelihood of possible end case scenarios, thereby facilitating the decision making process during operations. This paper describes the process of adjusting PRA models based on observed spacecraft data, on one hand, and utilizing the models for insight into the future system behavior on the other hand. While PRA models are typically used as a decision aid during the design phase of a space mission, we advocate adjusting them based on the observed behavior of the spacecraft and utilizing them for decision support during the operations phase.

dynamic fault trees↗

DOE OSTI2018

Development of an integrated model for energy systems planning and carbon dioxide mitigation under uncertainty – Tradeoffs between two-level decision makers

Highlights: • A bi-level model is developed for energy systems planning and carbon dioxide mitigation. • Tradeoffs between two-level decision-makers’ demands are quantified under uncertainty. • The energy and environmental impact of CO{sub 2} mitigation policy is analyzed for Beijing. • Results provide a range of decision alternatives between system optimality and reliability. A bi-level fuzzy programming (BFLP) method was developed for energy systems planning (ESP) and carbon dioxide (CO{sub 2}) mitigation under uncertainty. BFLP could handle fuzzy information and leader-follower problem in decision-making processes. It could also address the tradeoffs among different decision makers in two decision-making levels through prioritizing the most important goal. Then, a BFLP-ESP model was formulated for planning energy system of Beijing, in which the upper-level objective is to minimize CO{sub 2} emission and the lower-level objective is to minimize the system cost. Results provided a range of decision alternatives that corresponded to a tradeoff between system optimality and reliability under uncertainty. Compared to the single-level model with a target to minimize system cost, the amounts of pollutant/CO{sub 2} emissions from BFLP-ESP were reduced since the study system would prefer more clean energies (i.e. natural gas, LPG and electricity) to replace coal fuel. Decision alternatives from BFLP were more beneficial for supporting Beijing to adjust its energy mix and enact its emission-abatement policy. Results also revealed that the low-carbon policy for power plants (e.g., shutting down all coal-fired power plants) could lead to a potentially increment of imported energy for Beijing, which would increase the risk of energy shortage. The findings could help decision makers analyze the interactions between different stakeholders in ESP and provide useful information for policy design under uncertainty.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

DOE OSTI2013

Decision support models for solid waste management: Review and game-theoretic approaches

Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decision support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2025

First-of-a-Kind Risk-Informed Digital Twin for Operational Decision Making

A digital twin (DT) is a digital model or a collection of models of a physical entity. DTs in the nuclear arena can be used from plant design through decommissioning. Decisions are typically a priori or made offline. Risk-informed decision making is identifying what can go wrong, its frequency, and the consequences of its failure. Ideally risk-informed decision making reflects the current state of the plant and provides a decision in real time. Traditionally, probabilistic risk assessments (PRAs) evaluate the failures of safety systems, the risk of core damage, and the offsite dose as the consequence. However, this DT evaluates the decisions on the control side rather than the protection side. It uses the same risk methods to probabilistically inform the decision-making process but in a different way. Rather than evaluating the risk of core damage, this DT evaluates the likelihood of avoiding a trip set point while maintaining plant safety. Performance-based assessments are identified via its probabilistic evaluation of operational alternatives based on system status. Because the purpose of the control system is to maintain system variables within prescribed operating ranges, upsets or challenges that can exceed a trip set point resulting in a plant transient and a challenge to plant mitigating systems based on actual plant conditions, are evaluated to safely maintain the plant within the operating ranges. The probabilistic portion of the model is autonomously and automatically adjusted, and the metric of interest (i.e. likelihood of avoiding a trip set point) is recalculated. The digital representation of the physical system (i.e. the DT) performs a deterministic performance–based assessment of the probabilistically identified alternatives identified to validate the probabilistic assessment. A decision-making algorithm selects the appropriate option based on the probabilistic and deterministic assessments and transmits a control signal to a component(s) to initiate a corrective action or informs an operator of its decision.

digital twin↗

NASA NTRSDate not supplied

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. 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. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that 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. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support↗

NASA NTRSDate not supplied

Clinical Decision Support - Overview and Update

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. 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. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that 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. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support system↗

NASA NTRSDate not supplied

How to Educate Decision Makers on the Value and Necessity of Modal Testing and Model Correlation: Tips for Young Engineers

Engineers need to effectively communicate the justification and value of their modal testing and model correlation in terminology familiar to decision makers as it relates to the program’s risk tolerance. This communication must relate to the program’s risk tolerance and the metrics used to judge the performance of both the program and individual decision makers. The challenge is the terminologies familiar to engineers and decision makers are quite different and seemingly unrelated. The engineering profession has developed a specific terminology to solve highly technical issues, which are many times themselves unique to very specific engineering problems. It is all too easy for engineers to believe that everyone in their organization, including the decision makers, has an intrinsic understanding of what they do and the value it brings to the program’s success. This is especially true for young engineers who have recently spent the last four plus years in an academic engineering learning environment, which has a highly technical research oriented atmosphere. Effective communication with decision makers is increasingly important as the technical breadth and practical program and project experience level for up and coming decision makers diminishes. It is not unusual for the decision makers to have technical knowledge in a domain different from structural dynamics (e.g., electronics or systems). Competition among satellite manufactures has increased the focus on programmatic cost and ability to deliver on schedule. NASA programs are also seeing more restrictive programmatic cost and schedule constraints, which impact both analysis and testing. It should also be noted that a comprehensive suite of tests are required to verify a satellite’s design capability with some margin. These tests include static strength verification tests, shock, acoustic, and vibration tests (sine and random) of systems, subsystems, and components. Each of these verification tests provide opportunities for model correlation and risk reduction. It is important to recognize dynamic loads/modal test models may not include all of the flight hardware (i.e., harness, coax, waveguides, connectors, etc.) and the previously mentioned tests are still required for qualification/verification of the design. This paper provides tips to young engineers on how to bridge this communications gap, have a better understanding of the environment in which decision makers operate, and assist them to better support successful missions. While this paper primarily focuses on modal testing and model correlation as related to spacecraft missions, the concepts and recommendations presented here are equally applicable to other fields such as aeronautics, automotive, power generation, etc.

Decision Maker↗