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IMPACT, A Tool Suite for Crew Health and Performance System Trade Analyses and Decision Support- Transition to Operations

Mission planners, systems engineers, and clinicians that support crew health and performance face very difficult choices on upcoming exploration missions. Given that there will be a heavily constrained mass and volume allocation for a medical system on these missions, what medical capability should be manifested to minimize both medical risk and mission risk? Given that not all promising research and technology proposals can be funded, how can proposals be prioritized so that those funded research investments produce the maximum benefit in reducing overall medical risk? The Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) project seeks to answer these kinds of questions and others to support upcoming exploration missions. IMPACT enables risk-informed and evidence-based trade space analysis for future space vehicles, missions, and systems. This presentation will discuss the long-term HRP and ExMC vision for the larger ecosystem of tools, which include an updated medical database, consisting of an Evidence Library for medical conditions and a medical item database (MedID) for medical resources, dynamic Probabilistic Risk Assessment (PRA) capabilities, System Modeling Language (SysML) models, and contextual data visualizations of output data. IMPACT is the result of a multi-center collaborative effort. The trade space analyses performed by IMPACT can directly inform mission, vehicle, and habitat development by quantifying medical risk, given a design reference mission, crew attributes and a set of medical capabilities. This presentation will update the audience on the development status of the IMPACT tool suite as it comes out of its System Acceptance Review (SAR) and nears Transition to Operations (TTO). It will review IMPACT’s constituent parts, briefly discuss typical outputs, and outline the plans for transitioning to operations, currently scheduled for later in FY24. Recent development successes on the IMPACT project include the integration of the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) v2.0 to accommodate segmented missions with multiple carriers and medical systems, full onboarding of the IMPACT Medical Database (IMPACT-MD), clustering medical resources and skills into medical capabilities and mutually-dependent bundles, verification of IMPACT-MD, and the ability to perform trade analyses on different medical sets, different design reference missions (DRM), with different crew complements and extra-vehicular activity (EVA) schedules.

IMPACT↗

Assessment and Control of Spacecraft Charging Risks on the International Space Station

Electrical interactions between the F2 region ionospheric plasma and the 160V photovoltaic (PV) electrical power system on the International Space Station (ISS) can produce floating potentials (FP) on the ISS conducting structure of greater magnitude than are usually observed on spacecraft in low-Earth orbit. Flight through the geomagnetic field also causes magnetic induction charging of ISS conducting structure. Charging processes resulting from interaction of ISS with auroral electrons may also contribute to charging albeit rarely. The magnitude and frequency of occurrence of possibly hazardous charging events depends on the ISS assembly stage (six more 160V PV arrays will be added to ISS), ISS flight configuration, ISS position (latitude and longitude), and the natural variability in the ionospheric flight environment. At present, ISS is equipped with two plasma contactors designed to control ISS FP to within 40 volts of the ambient F2 plasma. The negative-polarity grounding scheme utilized in the ISS 160V power system leads, naturally, to negative values of ISS FP. A negative ISS structural FP leads to application of electrostatic fields across the dielectrics that separate conducting structure from the ambient F2 plasma, thereby enabling dielectric breakdown and arcing. Degradation of some thermal control coatings and noise in electrical systems can result. Continued review and evaluation of the putative charging hazards, as required by the ISS Program Office, revealed that ISS charging could produce a risk of electric shock to the ISS crew during extra vehicular activity. ISS charging risks are being evaluated in ongoing ISS charging measurements and analysis campaigns. The results of ISS charging measurements are combined with a recently developed detailed model of the ISS charging process and an extensive analysis of historical ionospheric variability data, to assess ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA analysis (estimated frequency of occurrence and severity of the charging hazards) are then used to select the hazard control strategy that provides the best overall safety and mission success environment for ISS and the ISS crew. This paper presents: 1) a summary of ISS spacecraft charging analysis, measurements, observations made to date, 2) plans for future ISS spacecraft charging measurement campaigns, and 3) a detailed discussion of the PRA strategy used to assess ISS spacecraft charging risks and select charging hazard control strategies

Koontz, Steve↗

NASA System Safety Handbook: System Safety Framework and Concepts for Implementation - Volume 1

System safety assessment is defined in NPR 8715.3C, NASA General Safety Program Requirements as a disciplined, systematic approach to the analysis of risks resulting from hazards that can affect humans, the environment, and mission assets. Achievement of the highest practicable degree of system safety is one of NASA's highest priorities. Traditionally, system safety assessment at NASA and elsewhere has focused on the application of a set of safety analysis tools to identify safety risks and formulate effective controls.1 Familiar tools used for this purpose include various forms of hazard analyses, failure modes and effects analyses, and probabilistic safety assessment (commonly also referred to as probabilistic risk assessment (PRA)). In the past, it has been assumed that to show that a system is safe, it is sufficient to provide assurance that the process for identifying the hazards has been as comprehensive as possible and that each identified hazard has one or more associated controls. The NASA Aerospace Safety Advisory Panel (ASAP) has made several statements in its annual reports supporting a more holistic approach. In 2006, it recommended that "... a comprehensive risk assessment, communication and acceptance process be implemented to ensure that overall launch risk is considered in an integrated and consistent manner." In 2009, it advocated for "... a process for using a risk-informed design approach to produce a design that is optimally and sufficiently safe." As a rationale for the latter advocacy, it stated that "... the ASAP applauds switching to a performance-based approach because it emphasizes early risk identification to guide designs, thus enabling creative design approaches that might be more efficient, safer, or both." For purposes of this preface, it is worth mentioning three areas where the handbook emphasizes a more holistic type of thinking. First, the handbook takes the position that it is important to not just focus on risk on an individual basis but to consider measures of aggregate safety risk and to ensure wherever possible that there be quantitative measures for evaluating how effective the controls are in reducing these aggregate risks. The term aggregate risk, when used in this handbook, refers to the accumulation of risks from individual scenarios that lead to a shortfall in safety performance at a high level: e.g., an excessively high probability of loss of crew, loss of mission, planetary contamination, etc. Without aggregated quantitative measures such as these, it is not reasonable to expect that safety has been optimized with respect to other technical and programmatic objectives. At the same time, it is fully recognized that not all sources of risk are amenable to precise quantitative analysis and that the use of qualitative approaches and bounding estimates may be appropriate for those risk sources. Second, the handbook stresses the necessity of developing confidence that the controls derived for the purpose of achieving system safety not only handle risks that have been identified and properly characterized but also provide a general, more holistic means for protecting against unidentified or uncharacterized risks. For example, while it is not possible to be assured that all credible causes of risk have been identified, there are defenses that can provide protection against broad categories of risks and thereby increase the chances that individual causes are contained. Third, the handbook strives at all times to treat uncertainties as an integral aspect of risk and as a part of making decisions. The term "uncertainty" here does not refer to an actuarial type of data analysis, but rather to a characterization of our state of knowledge regarding results from logical and physical models that approximate reality. Uncertainty analysis finds how the output parameters of the models are related to plausible variations in the input parameters and in the modeling assumptions. The evaluation of unrtainties represents a method of probabilistic thinking wherein the analyst and decision makers recognize possible outcomes other than the outcome perceived to be "most likely." Without this type of analysis, it is not possible to determine the worth of an analysis product as a basis for making decisions related to safety and mission success. In line with these considerations the handbook does not take a hazard-analysis-centric approach to system safety. Hazard analysis remains a useful tool to facilitate brainstorming but does not substitute for a more holistic approach geared to a comprehensive identification and understanding of individual risk issues and their contributions to aggregate safety risks. The handbook strives to emphasize the importance of identifying the most critical scenarios that contribute to the risk of not meeting the agreed-upon safety objectives and requirements using all appropriate tools (including but not limited to hazard analysis). Thereafter, emphasis shifts to identifying the risk drivers that cause these scenarios to be critical and ensuring that there are controls directed toward preventing or mitigating the risk drivers. To address these and other areas, the handbook advocates a proactive, analytic-deliberative, risk-informed approach to system safety, enabling the integration of system safety activities with systems engineering and risk management processes. It emphasizes how one can systematically provide the necessary evidence to substantiate the claim that a system is safe to within an acceptable risk tolerance, and that safety has been achieved in a cost-effective manner. The methodology discussed in this handbook is part of a systems engineering process and is intended to be integral to the system safety practices being conducted by the NASA safety and mission assurance and systems engineering organizations. The handbook posits that to conclude that a system is adequately safe, it is necessary to consider a set of safety claims that derive from the safety objectives of the organization. The safety claims are developed from a hierarchy of safety objectives and are therefore hierarchical themselves. Assurance that all the claims are true within acceptable risk tolerance limits implies that all of the safety objectives have been satisfied, and therefore that the system is safe. The acceptable risk tolerance limits are provided by the authority who must make the decision whether or not to proceed to the next step in the life cycle. These tolerances are therefore referred to as the decision maker's risk tolerances. In general, the safety claims address two fundamental facets of safety: 1) whether required safety thresholds or goals have been achieved, and 2) whether the safety risk is as low as possible within reasonable impacts on cost, schedule, and performance. The latter facet includes consideration of controls that are collective in nature (i.e., apply generically to broad categories of risks) and thereby provide protection against unidentified or uncharacterized risks.

Dezfuli, Homayoon↗

Probabilistic Asteroid Impact Risk Assessment for the Hypothetical PDC17 Impact Exercise

Performing impact risk assessment for the 2017 Planetary Defense Conference (PDC17) hypothetical impact exercise, to take place at the PDC17 conference, May 15-20, 2017. Impact scenarios and trajectories are developed and provided by NASA's Near Earth Objects Office at JPL (Paul Chodas). These results represent purely hypothetical impact scenarios, and do not reflect any known asteroid threat. Risk assessment was performed using the Probabilistic Asteroid Impact Risk (PAIR) model developed by the Asteroid Threat Assessment Project (ATAP) at NASA Ames Research Center. This presentation includes sample results that may be presented or used in discussions during the various stages of the impact exercisecenter dot Some cases represent alternate scenario options that may not be used during the actual impact exercise at the PDC17 conference. Updates to these initial assessments and/or additional scenario assessments may be performed throughout the impact exercise as different scenario options unfold.

Asteroid Impact Risk↗

MEDPRAT-SEL: Medical Resource Set Selector Searching High-Dimensionality Space

NASA Human Research Program's (HRP) next generation risk model closes the loop on medical risk and resource evaluation, providing researchers with a tool to assess and choose capabilities scientifically. The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) simulator (SIM) evaluates resources in terms of medical benefit, such as reduced crew quality time lost (QTL), vs. cost, in mass or volume. The MEDPRAT resource set selector (SEL) searches the space of resource benefits v. cost, closing a feedback loop around the simulator, thus selecting resource sets with best benefit for cost. We discuss the design and results of the resource set selector. NASA HRP's emphasis on scientific assessment of risk, PRA, has led to the Cross-cutting Computational Modeling Project (CCMP).

Leinweber, Lawrence↗

Evaluating Faulty State Occurrence in Wildfire UAS Missions Using Markov Chains

As autonomous technology advances, unmanned aircraft systems are increasingly integrated into emergency response missions, such as wildfire response. These systems must be be safe with less risk than non-autonomous counter parts, yet quantifying the risk associated with present-day and future systems conventionally relies solely on expert opinion and little data. Instead, combining narrative mishap reports with probabilistic analysis can provide a method for evolutionary and timely risk analysis. In this paper, we present a framework for a data-driven probabilistic risk assessment style analysis, where hazard events and rates originate from documented UAS mishaps. The framework is applied to a UAS mapping mission in wildfire response, including a fault tree analysis, event tree analysis, and probabilistic analysis using Markov Chains. The analysis provides an enumeration of hazards in the system, hazard events that can lead to faults, the probability of a mission experiencing any fault, the probability of experiencing a specific fault, and the expected time spent until faulty states occur in present-day operations.

risk analysis↗

Evaluating Faulty State Occurrence in Wildfire UAS Missions Using Markov Chains

As autonomous technology advances, unmanned aircraft systems are increasingly integrated into emergency response missions, such as wildfire response. These systems must be be safe with less risk than non-autonomous counter parts, yet quantifying the risk associated with present-day and future systems conventionally relies solely on expert opinion and little data. Instead, combining narrative mishap reports with probabilistic analysis can provide a method for evolutionary and timely risk analysis. In this paper, we present a framework for a data-driven probabilistic risk assessment style analysis, where hazard events and rates originate from documented UAS mishaps. The framework is applied to a UAS mapping mission in wildfire response, including a fault tree analysis, event tree analysis, and probabilistic analysis using Markov Chains. The analysis provides an enumeration of hazards in the system, hazard events that can lead to faults, the probability of a mission experiencing any fault, the probability of experiencing a specific fault, and the expected time spent until faulty states occur in present-day operations.

risk analysis↗

Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

Butler, Doug↗

Improving the Fidelity of Capability & Resource Weighting in A Probalistic Risk Assessment Model for Spaceflight

INTRODUCTION NASA’s Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool uses Probabilistic Risk Assessment (PRA) to provide an evidence-based, data-driven estimate of how medical system capabilities affect mission outcomes. IMPACT maps condition incidence to available resources thereby facilitating the calculation of outcome metrics that allow the estimation of mission medical risk. Conditions can be nominally categorized as either treated or untreated depending on the availability of necessary diagnostic and therapeutic capabilities. This categorization enables IMPACT to estimate the effect of various medical system configurations on mission outcomes such as crew mortality, disability, crew member down-time, return to duty/recovery, and need for evacuation. IMPACT currently employs an equal weighting, “partial credit” approach to define treatment in which each of the capabilities associated with a given condition contributes an equal amount to management of the condition. This feature enables IMPACT to report values in between “fully untreated” and “fully treated” based on the proportion of capabilities available within the model. However, as is normal in medical/clinical practice, not all individual capabilities contribute equally to medical care. For example, the ability to provide intramuscular epinephrine during an anaphylactic episode contributes more likelihood of overall management success than does the administration of oral diphenhydramine. We hypothesize that weighting the relative contribution of each capability to each specific condition will improve outcome prediction and therefore will better provide mission planners with more nuanced and accurate options when designing space medical systems. METHODS Using a five-point Fibonacci scaling sequence (1, 2, 3, 5, 8) subject matter experts from NASA’s Exploration Medical Capabilities (ExMC) element assigned relative contribution weighting values to each identified capability within IMPACT. Since the relative importance of each capability varies depending on the specific condition, the resulting “partial” weighting was completed for more than 1,600 individual weighting assignments for 666 capabilities across 121 conditions. Each assignment required three-physician concurrence based on the overall importance of the capability to the diagnosis and management of the condition being considered and the difficulty with which it could be improvised by the crew. Once complete, 100,000 IMPACT simulations were run for a 6-month Lunar mission with a 30-day surface stay to evaluate the effect of this modification of the model. RESULTS Partial weighting significantly decreased predicted task time loss (TTL), evacuation, and loss of crew life without causing significant changes to the recommended medical system design. CONCLUSIONS The paucity of real-world referent data to support long-duration space missions of this type limits the ability to judge one predictive analytics method as superior to another. However, since the proposed method significantly reduces and optimizes outcome risks—without changing the medical system design—incorporating a partial weighting methodology is likely to provide a more accurate and operationally-relevant representation of medical risk without compromising IMPACTs ability to inform overarching medical system requirements.

Steller JG↗

Risk Assessment Metrics for NASA Fission Reactor Applications

Risk assessment is an important part of many NASA activities. In August 2019, the White House issued NSPM-20, which defines acceptable levels of risk for nuclear launches, but does not prescribe the particular methodologies or metrics that are to be used for comparison to the defined acceptance criteria. There are a variety of metrics that are possible and can be readily generated by a probabilistic risk assessment (PRA). This paper will explore alternative metrics that can be provided, along with some discussion of their characteristics and important factors to consider during a space fission reactor risk analysis.

Probabilistic Risk Assessment↗

Impact, a Tool Suite for Crew Health and Performance System Trade Analyses and Decision Support - Status of Development

Mission planners, systems engineers, and clinicians that support crew health and performance face very difficult choices on upcoming exploration missions. Given that there will be a heavily constrained mass and volume allocation for a medical system on these missions, what medical capability should be manifested to minimize both medical risk and mission risk? Given that not all promising research and technology proposals can be funded, how can proposals be prioritized so that those funded research investments produce the maximum benefit in reducing overall medical risk? The Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) project seeks to answer these kinds of questions and others to support upcoming exploration missions. IMPACT enables risk-informed and evidence-based trade space analysis for future space vehicles, missions, and systems. This presentation will discuss the long-term HRP and ExMC vision for the larger ecosystem of tools, which include an updated medical database (consisting of an Evidence Library for medical conditions and a medical item database (MedID) for medical resources), dynamic Probabilistic Risk Assessment (PRA) capabilities, System Modeling Language (SysML) models, and contextual data visualizations of output data. IMPACT is the result of a multi-center collaborative effort. The trade space analyses performed by IMPACT can directly inform mission, vehicle, and habitat development by quantifying medical risk, given a design reference mission, crew attributes and a set of medical capabilities. This presentation will update the audience on the development status of the tool suite, its constituent parts and the plans for when it will deploy as an operational product, currently scheduled for the end of FY22. Recent development successes on the IMPACT project include the ability to cluster medical resources into medical capabilities and mutually-dependent bundles, the ability to perform trade analyses on different medical sets, different DRMs, and different crew complements, and the ability to specify mission segments as periods of time assigned to one or more members of the crew during which unique mission events occur (e.g., extravehicular activities, surface operations, gravity well adaptations, etc.). IMPACT is gearing up for its verification and validation phase to compile the data package necessary for a successful Transition to Operations (TtO), per the guidance in NPR 8900.1B .

IMPACT↗

Improving Safety on the International Space Station: Transitioning to Electronic Emergency Procedure Books on the International Space Station

The National Aeronautics and Space Administration (NASA) originally designed the International Space Station (ISS) to operate until 2015, but have extended operations until at least 2020. As part of this very dynamic Program, there is an effort underway to simplify the certification of Commercial ]of ]the ]Shelf (COTS) hardware. This change in paradigm allows the ISS Program to take advantage of technologically savvy and commercially available hardware, such as the iPad. The iPad, a line of tablet computers designed and marketed by Apple Inc., was chosen to support this endeavor. The iPad is functional, portable, and could be easily accessed in an emergency situation. The iPad Electronic Flight Bag (EFB), currently approved for use in flight by the Federal Aviation Administration (FAA), is a fraction of the cost of a traditional Class 2 EFB. In addition, the iPad fs ability to use electronic aeronautical data in lieu of paper in route charts and approach plates can cut the annual cost of paper data in half for commercial airlines. ISS may be able to benefit from this type of trade since one of the most important factors considered is information management. Emergency procedures onboard the ISS are currently available to the crew in paper form. Updates to the emergency books can either be launched on an upcoming visiting vehicle such as a Russian Soyuz flight or printed using the onboard ISS printer. In both cases, it is costly to update hardcopy procedures. A new operations concept was proposed to allow for the use of a tablet system that would provide a flexible platform to support space station crew operations. The purpose of the system would be to provide the crew the ability to view and maintain operational data, such as emergency procedures while also allowing Mission Control Houston to update the procedures. The ISS Program is currently evaluating the safety risks associated with the use of iPads versus paper. Paper products can contribute to the flammability risk and require manual updates that take time away from research tasks. The ISS program has recently purchased three iPads for the astronauts and the certification has been approved. The crew is currently using the iPads onboard. The results of this analysis could be used to discern whether the iPad is a viable option for use in emergencies by assessing the risk posture through the development of a quantitative probabilistic risk assessment (PRA).

Carter-Journet, Katrina↗

Crowd Sourcing Medical Data Collection Using Medical Students

OBJECTIVE We undertook an upgrade of the Evidence Library database of NASA HRP’s Integrated Medical Model, assessing 120 medical conditions which integrate with a novel probabilistic risk assessment (IMPACT) tool of medical risk and resource utilization for long duration exploration human spaceflight. This data collection process included a selection of these conditions crowd sourced over one year via three 4-week medical student electives at the University of Colorado School of Medicine (IDPT 8059 Space Medicine: Human Spaceflight Factors & Medical Risk Assessment). Students undertook a rapid systematic review of each medical condition, under close preceptors with backgrounds in clinical medicine, library science, epidemiology, biostatistics, and evidence-based medicine. As part of the elective, students also received instruction in core space medicine concepts, evidence based medicine and problem based learning sessions as a flight surgeon supporting a simulated Mars mission. METHODS The list of 120 medical conditions includes both common, terrestrial illness/injury (epistaxis, diverticulitis) as well as spaceflight-specific ones (space adaptation conditions, EVA-related injuries). A rapid systematic review process was developed that would allow students to find the data for determining disease incidence/prevalence, return to definitive care (often a surrogate such as hospitalization rates), loss of crew life, and treatment duration. Each data point required a tailored, specialized search process using different databases and corresponding specialized search filters. Databases were selected on their ability to provide high quality literature in an efficient manner and prioritized by their ability to provide graded evidence via a set rubrics specific to human spaceflight. Students were responsible for performing all literature searches and identifying the highest quality available evidence for each data point. Completed student data sheets underwent initial review by faculty preceptors followed by a secondary editing review by the ExMC Clinical Science Team. RESULTS Over the course of three electives, approximately 105 medical conditions were researched by students using spreadsheets with pre-crafted search strategies. Overall, this process was successful in allowing students to perform the preponderance of work to update incidence, treatment duration, return to definitive care, and loss of crew life data points. Students were successful in running searches, identifying the necessary data points within the literature, and determining the types of terrestrial data that most aligns with the astronaut population for successful completion of their tasks. Limitations included variable student experience with search methodologies [PubMed], differing values of evidence grading [best practice evidence based medicine vs. relevant to spaceflight], and students’ unfamiliarity with spaceflight specific conditions. CONCLUSION Finding the relevant literature for medical conditions in spaceflight within terrestrial databases in a systematic method is time consuming and not intuitive. However, the stepwise process that balanced sensitivity with specificity allowed for students to be highly successful in a short amount of time. Additionally, as the process was refined over the course of three electives, preceptors were better able to anticipate where students were likely to encounter barriers, which allowed the course to be adjusted to account for certain data points needing more time for completion. This replicable process may be an efficient way to accomplish rapid systematic reviews for a large volume of data in a short amount of time.

J Lemery↗

NSTS Orbiter auxiliary power unit turbine wheel cracking risk assessment

The present investigation of turbine-wheel cracking problems in the hydrazine-fueled APU turbine wheel of the Space Shuttle Orbiter's Main Engines has indicated the efficacy of systematic probabilistic risk assessment in flight certification and safety resolution. Nevertheless, real crack-initiation and propagation problems do not lend themselves to purely analytical studies. The high-cycle fatigue problem is noted to generally be unsuited to probabilistic modeling, due to its extremely high degree of intrinsic scatter. In the case treated, the cracks appear to trend toward crack arrest in a low cycle fatigue mode, due to a detuning of the resonance model.

Cruse, T. A.↗

PRA and Conceptual Design

Once a project obtains approval, decision makers have to consider a variety of alternative paths for completing the project and meeting the project objectives. How decisions are made involves a variety of elements including: cost, experience, current technology, ideologies, politics, future needs and desires, capabilities, manpower, timing, available information, and for many ventures management needs to assess the elements of risk versus reward. The use of high level Probabilistic Risk Assessment (PRA) Models during conceptual design phases provides management with additional information during the decision making process regarding the risk potential for proposed operations and design prototypes. The methodology can be used as a tool to: 1) allow trade studies to compare alternatives based on risk, 2) determine which elements (equipment, process or operational parameters) drives the risk, and 3) provide information to mitigate or eliminate risks early in the conceptual design to lower costs. Creating system models using conceptual design proposals and generic key systems based on what is known today can provide an understanding of the magnitudes of proposed systems and operational risks and facilitates trade study comparisons early in the decision making process. Identifying the "best" way to achieve the desired results is difficult, and generally occurs based on limited information. PRA provides a tool for decision makers to explore how some decisions will affect risk before the project is committed to that path, which can ultimately save time and money.

DeMott, Diana↗

Integrated Medical Model Project - Overview and Summary of Historical Application

Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions: Historically, IMM simulations support Science and Technology planning, Exploration mission planning, and ISS program operations by supplying simulation support, iMED data information, and subject matter expertise to Crew Health and Safety and the HRP. Upcoming release of IMM version 4.0 seeks to provide enhanced functionality to increase the quality of risk decisions made using the IMM through a more accurate representation of the real world system.

Myers, J.↗

The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be used to help assess risk, develop mitigation strategies, and optimize medical systems for exploration space flight missions.

Kerstman, Eric↗