Search NASA⌕ Search

SEARCH · Search NASA

Results for “Medical conditions”

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

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

At least 19 records
All sourcesNASA NTRSDOE OSTI
NASA NTRS2019

Development of an Accepted Medical Condition List for Exploration Medical Capability Scoping

The Accepted Medical Conditions List (AMCL) is a product designed to provide a traceable, repeatable, evidence-based consensus process for scoping the medical capability needs for future design reference missions (DRMs) and upcoming programs. These include a Mars transit DRM and a shorter duration cis-lunar DRM. The development of a baseline AMCL by the Exploration Medical Capability (ExMC) Element will assist the effort to identify high priority medical capabilities for inclusion in mission and vehicle planning and provide traceable and documented clinical needs to the Systems Engineering teams tasked with requirements development and design work.

Medical Condition List↗
NASA NTRS2011

The Near Earth Asteroid Medical Conditions List

Purpose: The Exploration Medical Capability (ExMC) element is one of six elements within NASA s Human Research Program (HRP) and is responsible for addressing the risk of "the inability to adequately recognize or treat an ill or injured crewmember" for exploration-class missions. The Near Earth Asteroid (NEA) Medical Conditions List, constructed by ExMC, is the first step in addressing the above-mentioned risk for the 13-month long NEA mission. The NEA mission is being designed by NASA's Human Space Flight Architecture Team (HAT). The purpose of the conditions list is to serve as an evidence-based foundation for determining which medical conditions could affect a crewmember during the NEA mission, which of those conditions would be of concern and require treatment, and for which conditions a gap in knowledge or technology development exists. This information is used to focus research efforts and technology development to ensure that the appropriate medical capabilities are available for exploration-class missions. Scope and Approach: The NEA Medical Conditions List is part of a broader Space Medicine Exploration Medical Conditions List (SMEMCL), which incorporates various exploration-class design reference missions (DRMs). The conditions list contains 85 medical conditions which could occur during space flight and which are derived from several sources: Long-Term Surveillance of Astronaut Health (LSAH) in-flight occurrence data, The Space Shuttle (STS) Medical Checklist, The International Space Station (ISS) Medical Checklist, and subject matter expert opinion. Each medical condition listed has been assigned a clinical priority and a clinical priority rationale based on incidence, consequence, and mitigation capability. Implementation: The conditions list is a "living document" and as such, new conditions can be added to the list, and the priority of conditions on the list can be adjusted as the DRM changes, and as screening, diagnosis, or treatment capabilities change. The NEA medical conditions list was used recently as the basis for identifying gaps in in-flight medical evaluation (screening) capabilities. Learning Objectives: The audience will become familiar with the approach taken by NASA's Exploration Medical Capability element in addressing the risk of inability to recognize and treat medical conditions in the setting of a Near Earth Asteroid mission. Which one of the following statements is incorrect? a) The Near Earth Asteroid (NEA) medical conditions list includes 85 medical conditions which could occur during space flight. b) Each condition on the NEA medical conditions list has been assigned a clinical priority and a clinical priority rationale. c) The NEA medical conditions list targets a mission to Mars. d) The NEA medical conditions list should be viewed as a "living document" where new conditions can be added and clinical priorities adjusted to address changes in the design reference mission or medical capabilities. The incorrect answer is c). The NEA medical conditions list targets a mission to a Near Earth Asteroid.

Barr, Yael R.↗
NASA NTRS2011

The Space Medicine Exploration Medical Condition List

Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

Watkins, Sharmi↗
NASA NTRS2013

A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report

This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

Lewis, Robert↗
NASA NTRSDate not supplied

Derivation of Capabilities and Resources for Treating Medical Conditions in Deep Space

BACKGROUND: Medical care in spaceflight requires the adaptation of terrestrial standards to the constraints of the space environment. However, there is often conflict between the ideal resources required for treatment and diagnosis of a medical condition, and the constraints on their mass, volume, data needs, etc. This optimization of trades between medical risk and resources will be a significant challenge for deep space medical system design. METHODS: A team of physicians with a broad range of expertise reviewed the 120 medical conditions on the condition list for NASA’s Informing Mission Planning via analysis of Complex Tradespaces Medical Database (IMPACT-MD). Each team member was assigned a subset of conditions based on their experience and training. The assigned physician generated a proposed list of capabilities, definitions, and resources required to treat each condition based on terrestrial practice guidelines, medical literature, and subject matter expertise. Additional specialists were consulted for conditions where expertise was not present within the main group. The proposed list was then reviewed by the broader team and modified as needed to achieve consensus. Each capability and resource was then assigned parameters to define quantity required per medical event, necessity, training level required, and primacy order of any alternative resources. These capabilities and resources were placed into condition specific tables and delivered to a team of engineers who added mass and volume data for each specific resource and converted the table into a database for use as input to a computational model to simulate spaceflight (IMPACT) DISCUSSION: This process ensures that a minimum of three subject matter experts review and agree upon the scope of practice, medical diagnostic tools, and treatment modalities that would be necessary to address emergent and non-emergent conditions that may arise during spaceflight to inform requirements during the vehicle design phase. The method is scalable to any design reference mission and permits modification of the existing database as information, conditions or experience are added. By including specialists, generalists, and those with subject matter expertise in the spaceflight environment on the team, we ensure that the included capabilities represent a realistic and actionable foundation for planning deep space missions.

D R Levin↗
NASA NTRS2022

Development of an Accepted Medical Condition List for Exploration Medical Capability Scoping

Future NASA human spaceflight programs are on the verge of moving beyond Low Earth Orbit (LEO) to implement missions in lunar space and ultimately Mars. The mission constraints for these types of missions are expected to be progressively challenging for integration of Human Systems requirements into the vehicle and mission architectures. Mass and volume allocations are expected to become increasingly restrictive at the same time that mission realities will drive an increasing need for crew self-sufficiency in the maintenance and repair of both vehicle systems and human systems. To meet these challenges, a systematic, traceable, and repeatable approach to identifying, defining, and prioritizing medical capabilities is required. To provide a systematic and repeatable approach to defining and prioritizing clinical capabilities for spaceflight medicine, a clear process is required for delivering a list of prioritized medical capabilities to the Systems Engineering process that will delineate the mass, power, volume, and similar needs and the trade space analysis for a given space vehicle and mission architecture.

Rebecca Blue↗
NASA NTRS2016

Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions: ExMC Pharmacy Research Plan

The Exploration Medical Capabilities (ExMC) Element of NASA's Human Research Program is charged with identifying medical capabilities that can address the challenges of prevention, diagnosis, and treatment of disease and injuries that could occur during exploration missions beyond Earth's orbit. Faced with the obstacle of access to in-flight medical care, and limitations of vehicle space, time, and communications; it is necessary to prioritize what medical consumables are manifested for the flight, and which medical conditions are addressed. Studies of astronaut health establish the incidence of common and high risk medical conditions that require medical intervention during long-duration exploration missions. In 2000, the Institute of Medicine (IOM) convened a committee of experts, Committee on Creating a Vision for Space Medicine during Travel beyond Earth Orbit, to examine the issues surrounding astronaut health and safety for long duration space missions. Two themes run throughout the committee's final report: (1) that not enough is known about the risks to human health during long-duration missions beyond Earth's orbit or about what can effectively mitigate those risks to enable humans to travel and work safely in the environment of deep space and (2) that everything reasonable should be done to gain the necessary information before humans are sent on missions of space exploration (IOM, 2001). Although several spaceflight focused pharmaceutical research studies have been conducted, few have provided sufficient data regarding medication usage or potency changes during spaceflight. The Du pharmaceutical stability study assessed medications flown on space shuttles to and from the International Space Station (ISS) from 2006 until 2008; of which some medications were still viable beyond their expiration dates (Du et al, 2011). However, as with many spaceflight studies, the small 'n' associated with this study limits the ability to draw strong conclusions from it. Dr. Wotring and others have recently published articles containing information regarding medication usage, indications, and efficacy gleaned from spaceflight records (Wotring et al, 2015, 2016; Barger et al, 2014; Basner and Dinges, 2014). Although some conclusions can be drawn from these studies, the inability to fully quantify medication usage, indications, side effects, and effectiveness, limits insight as to which medications should be prioritized for further research.

Antonsen, Erik↗
NASA NTRSDate not supplied

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

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

A Nelson↗
NASA NTRSDate not supplied

Root Cause Analysis of the Data Refinement Process – Medical Conditions Capability Resource Tables

The medical system for spaceflight thus far has been designed to support missions in low earth orbit (LEO). Crew capabilities are limited and heavily dependent on the team of medical support staff at Mission Control Center (MCC) to guide diagnosis and management. However, missions to the Moon and Mars will suffer from several constraints that will make this ground support focused approach to care ineffective. In order to update and modify medical system design, NASA has relied on Probabilistic Risk Assessment (PRA) modeling to mitigate medical risk through trade space analysis. Specifically, capability resource tables (CRT’s) were developed to create a dataset of resources required to manage a list of accepted medical conditions significant in exploration spaceflight. With 120 conditions, this dataset contained hundreds of capabilities and thousands of resources with tens of thousands of cells of data. Initially these tables were built in excel for high throughput during development, but ultimately had to be transferred, managed, and modified into the Evidence Library database for modeling purposes. The process of collating and reviewing the Evidence Library revealed numerous errors in the dataset that had to be corrected through iterative changes. Several error types emerged during this process and can be broken into specific classifications defined as “input”, “transcription”, “structural”, “branching”, and “information”. In reviewing these error types through the root cause analysis (RCA) approach, we were able to identify the contributors to these errors which included single data review points, changing product end goals, limited software selection, time constraints and several others. By reviewing and evaluating the underlying causes we can provide possible system improvements that can be implemented for current and future data management in PRA model inputs.

A. Anderson↗
NASA NTRSDate not supplied

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

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

risk analysis↗
NASA NTRSDate not supplied

Inflight Medical Conditions Risk – Overview and Strategic Approach

The risk of adverse health outcomes and decrements in performance due to inflight medical conditions is among NASA’s “red” risks for Mars missions, scored at the highest likelihood and consequence on the rating scale. Importantly, this risk encompasses all possible medical conditions that might occur in spaceflight. At thesame time, exploration spaceflight will have significant resource constraints (mass, power, volume, data, etc.) and supplying the full complement of medical capabilities available on Earth will be impossible. Inevitably, medical conditions will develop during a human Mars mission and having inadequate inflight capabilities will have a negative impact on the health and performance of the astronauts, leading to adverse crew and/or mission outcomes.

B D Easter↗
NASA NTRSDate not supplied

Developing A New Medical Condition List for Exploration Spaceflight

For the last decade, the National Aeronautics and Space Administration (NASA) has utilized a probabilistic risk analysis tool called the Integrated Medical Model (IMM), which contains 100 medical conditions, to conduct medical trade-space analyses and risk assessments for International Space Station (ISS) operations. Planning for future missions to the Moon and Mars will require updated tools and evidence that consider the unique features of exploration missions. To address this need, the Exploration Medical Capability (ExMC) Element of the NASA Human Research Program is developing an advanced trade-space analysis tool suite, IMPACT. As a part of this effort, ExMC has produced the IMPACT version 1 Condition List (ICL 1.0) which expands the scope and definition of medical conditions.

Amy Jean Kreykes↗
NASA NTRSDate not supplied

Selection of Next Priority IMPACT Medical Conditions Based on Available Terrestrial and Spaceflight Data

BACKGROUND: As the era of exploration class missions begins, identification of medical conditions that may occur and require management becomes essential for the modeling of medical risk. To this end, NASA has developed IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces), a suite of tools to assist in assessment of medical risk analysis. It has incorporated an initial list of the 120 conditions of highest concern, labeled the IMPACT condition list 1.0 (ICL 1.0). This abstract describes a method for prioritizing the 92 conditions included on the Proposed Future Conditions List (PFCL) for inclusion in future iterations of the ICL. OVERVIEW: To construct the Prioritized Proposed Future Conditions List (P-PFCL), each condition on the PFCL was scored as “low,” “medium,” or “high” on each of four variables: incidence, likelihood of significant task impairment, diagnostic and treatment complexity, and treatment futility. Qualitative assessment using clinical judgement was utilized to score complexity, futility, and likelihood of impairment. Incidence was assessed quantitatively using spaceflight data and/or analog populations where available then assigned a score using established cutoffs. Logarithmic numerical values were assigned to each category label. A Prioritization Score was generated for each condition by taking the product of incidence and likelihood of task impairment (risk) divided by the product of complexity and futility (difficulty of care), with higher values corresponding to higher priority for future inclusion in the ICL. DISCUSSION: The described methods allow for the generation of a ranked P-PFCL to act as a decision support tool for selection of the next generation of modeled medical conditions. Some of the conditions ranked highly on the P-PFCL include EVA-related upper and lower extremity sprain/strain, iron deficiency, delirium, and hypertension, among others. While this effort does not attempt to quantify the absolute risk associated with each condition, it does attempt to semi-quantitatively estimate the risk of each condition relative to the other possible conditions. This tool in concert with subject matter expert opinion could optimize the future use of limited resources thereby producing a more accurate medical risk model, which will be essential to the upcoming exploration class missions.

Michael Pohlen↗
NASA NTRSDate not supplied

Methods for Determining Subsets of High Impact, Probabilistically Dependent Medical Conditions Represented in a Directed Graph

One of the longest standing questions in network theory is how a component influences other parts in the system, and how that role is affected when restricting the navigation through the network. The Katz score, one of many centrality measures created for this purpose, takes into account all possible walks through the network, penalizing each additional step in a walk by a scalar called the Katz parameter. This centrality measure often covers an infinite number of walks with infinite length. In this paper we identify the maximum path length which has influence on the Katz score. We ultimately provide guidance when deciding which Katz parameter to use as it depends on the path length of interest. We show how changing the Katz parameter affects the ranking of the vertices in some synthetic graphs as well as NASA's expert informed network of medical dependencies called the Susceptibility Inference Network (SIN).

Hunter Rehm↗
NASA NTRS2017

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system engineering. Because of the novel nature of the risks involved in exploration missions, new and complex ethical challenges are likely to be encountered. This document describes the relevant background and evidence that informs the development of an exploration medical system.

Antonsen,Erik↗