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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↗
NASA NTRS1994

Application of AI techniques to infer vegetation characteristics from directional reflectance(s)

Traditionally, the remote sensing community has relied totally on spectral knowledge to extract vegetation characteristics. However, there are other knowledge bases (KB's) that can be used to significantly improve the accuracy and robustness of inference techniques. Using AI (artificial intelligence) techniques a KB system (VEG) was developed that integrates input spectral measurements with diverse KB's. These KB's consist of data sets of directional reflectance measurements, knowledge from literature, and knowledge from experts which are combined into an intelligent and efficient system for making vegetation inferences. VEG accepts spectral data of an unknown target as input, determines the best techniques for inferring the desired vegetation characteristic(s), applies the techniques to the target data, and provides a rigorous estimate of the accuracy of the inference. VEG was developed to: infer spectral hemispherical reflectance from any combination of nadir and/or off-nadir view angles; infer percent ground cover from any combination of nadir and/or off-nadir view angles; infer unknown view angle(s) from known view angle(s) (known as view angle extension); and discriminate between user defined vegetation classes using spectral and directional reflectance relationships developed from an automated learning algorithm. The errors for these techniques were generally very good ranging between 2 to 15% (proportional root mean square). The system is designed to aid scientists in developing, testing, and applying new inference techniques using directional reflectance data.

Kimes, D. S.↗
NASA NTRS1991

Intelligent failure-tolerant control

An overview of failure-tolerant control is presented, beginning with robust control, progressing through parallel and analytical redundancy, and ending with rule-based systems and artificial neural networks. By design or implementation, failure-tolerant control systems are 'intelligent' systems. All failure-tolerant systems require some degrees of robustness to protect against catastrophic failure; failure tolerance often can be improved by adaptivity in decision-making and control, as well as by redundancy in measurement and actuation. Reliability, maintainability, and survivability can be enhanced by failure tolerance, although each objective poses different goals for control system design. Artificial intelligence concepts are helpful for integrating and codifying failure-tolerant control systems, not as alternatives but as adjuncts to conventional design methods.

Stengel, Robert F.↗
NASA NTRS2000

Remote Agent Experiment

Remote Agent (RA) is a model-based, reusable artificial intelligence (At) software system that enables goal-based spacecraft commanding and robust fault recovery. RA was flight validated during an experiment on board of DS1 between May 17th and May 21th, 1999.

Benard, Doug↗
NASA NTRS2003

Application of Artificial Intelligence Techniques in Uninhabitated Aerial Vehicle Flight

This paper describes the development of an application of Artificial Intelligence (AI) for Unmanned Aerial Vehicle (UAV) control. The project was done as part of the requirements for a class in AI at NOVA southeastern University and a beginning project at NASA Wallops Flight Facility for a resilient, robust, and intelligent UAV flight control system. A method is outlined which allows a base level application for applying an Artificial Intelligence method, Fuzzy Logic, to aspects of Control Logic for UAV flight. One element of UAV flight, automated altitude hold, has been implemented and preliminary results displayed.

Dufrene, Warren R., Jr.↗
NASA NTRS2004

Application of Artificial Intelligence Techniques in Uninhabited Aerial Vehicle Flight

This paper describes the development of an application of Artificial Intelligence (AI) for Unmanned Aerial Vehicle (UAV) control. The project was done as part of the requirements for a class in AI at NOVA Southeastearn University and a beginning project at NASA Wallops Flight Facility for a resilient, robust, and intelligent UAV flight control system. A method is outlined which allows a base level application for applying an Artificial Intelligence method, Fuzzy Logic, to aspects of Control Logic for UAV flight. One element of UAV flight, automated altitude hold, has been implemented and preliminary results displayed.

Dufrene, Warren R., Jr.↗
NASA NTRSDate not supplied

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

From May 8th to June 9th, 2023, I had the opportunity to participate in an experiential learning experience at Johnson Space Center in Houston, TX with Exploration Medical Capability (ExMC), an element of the NASA Human Research Program. During this research experience, I was not only able to work on the above titled research project, but also gain an immense exposure to the field of aerospace medicine, make numerous connections within the field, tour NASA facilities, as well as travel to the Aerospace Medical Association Annual Conference (AsMA) in New Orleans. To briefly introduce my project, it is well understood that the medical capabilities available to crew medical officers (CMOs) on the International Space Station will be different than the capabilities available and needed during deep space exploration missions to the Moon, Mars, and beyond. Ground support is particularly limited due to distance, communication delays (or lack of communication), and lack of resupply. Therefore, to support medical care by CMOs on these missions, robust clinical decision support systems (CDSSs) must be designed. The recent publication and public launch of generative artificial intelligence (AI) tools based upon large language models (LLM) such as ChatGPT provides the opportunity to create a smart assistant for onboard triage, diagnosis, and treatment of medical conditions. Ultimately, the overall purpose of the project was to research what AI tools currently exist or are in development, and to see how they might be implemented onboard during exploration class spaceflights of the future. The ExMC element is actively developing several tools to be used in preparation for and during deep space exploration missions. One of those tools, known as IMPACT, is a probabilistic risk assessment model which can be used to propose a desired medical system (based on mass and volume) and suggest the clinical outcomes likely to occur for a design reference mission (DRM). The group recently presented the IMPACT model and a DRM of interest titled “Modified Long Duration Lunar Orbital and Lunar Surface” (mLDLOLS) at the recent AsMA conference. The mLDLOLS mock mission is a 9 month and 6-day deep space exploration mission consisting of time in Moon’s orbit (3 months on the Gateway space station), on the lunar surface (3 months within habitat), and another 3 months on Gateway before return to Earth. For this DRM, IMPACT ultimately outlined a preferred medical system that was then associated with medical conditions considered to be most likely based on frequency, most likely to cause astronaut task time loss (TTL), most likely to cause return to definitive care (RTDC), and most likely cause loss of crew life (LOCL). IMPACT also highlighted the medical capabilities/skills that would be required to care for those medical conditions, such as performing a history of present illness or musculoskeletal exam with ultrasound. The primary objective of the project was to perform a survey of the AI tools and systems applicable to the conditions outlined for the proposed mLDLOLS mission. Using PubMed (including most relevant MeSH terms) and Google Scholar, we then created a robust annotated bibliography organized by condition. The 56-page and over 500 reference annotated bibliography was subsequently used to create a review outline that would become the basis for drafting of a future publication. For the review outline, we took those medical conditions researched within the annotated bibliography (condition-based approach) and deployed a systems-based approach, combining those medical conditions and related tools into ten categories. These categories included general/all-purpose CDSSs, tools to diagnose or manage respiratory, dermatologic, neurologic, auditory and vestibular, ophthalmic, musculoskeletal, infection-associated, and gynecologic conditions, as well as tools that could be deployed in the setting of trauma/emergency. With the completion of the 30-page outline, we then began drafting the review paper. To conclude the research experience, I presented the findings from our survey to the ExMC Clinical and Science team. With these objectives, I ultimately learned about the number of AI tools that exist today to assist medical professionals with the triage, diagnosis, and management of several medical conditions. These tools can span from chatbot assistants to help triage knee pain to vision transformer models that can identify ophthalmic conditions based on ocular surface images captured with a cell phone. We also highlighted the current gaps that exist in the literature alongside the advancements that are needed to make the desired CDSS for deep space exploration missions. With this experience, I certainly confirmed an existing career goal and identified several additional skills needed to become an aerospace medical doctor including knowledge of critical care in an extreme medicine setting, aerospace engineering and human integration systems, artificial intelligence, machine learning, and risk models. I also identified numerous transferable skills for this career goal including the basic knowledge of medicine (MD), deployment of the scientific method for critical thought about new scientific questions (PhD), review of published literature, including creating an annotated bibliography (PhD), as well as detailed scientific writing (PhD). The results of my research will likely guide the design of an all-encompassing onboard medical assistant for use during deep space exploration missions of the future. I plan on sharing the outcomes from this experience with my peers at a student seminar in the Fall semester on August 30th. During the seminar, I will detail the project, my experience at NASA and AsMA, as well as offer best practice guidelines for students entertaining similar experiences or careers. In conclusion, I would like to thank the WVU School of Medicine, Research and Graduate Education office, as well as NASA ExMC for the unwavering support of this life-changing experience.

Ryan A. Lacinski↗
NASA NTRS1994

A software architecture for hard real-time execution of automatically synthesized plans or control laws

The design of a flexible, real-time software architecture for trajectory planning and automatic control of redundant manipulators is described. Emphasis is placed on a technique of designing control systems that are both flexible and robust yet have good real-time performance. The solution presented involves an artificial intelligence algorithm that dynamically reprograms the real-time control system while planning system behavior.

Schoppers, Marcel↗
NASA NTRS2021

NASA Framework for the Ethical Use of Artificial Intelligence (AI)

The NASA Framework for the Ethical Use of Artificial Intelligence (AI) provides six key principles to guide NASA's use of AI. The principles are NASA's AI must be 1. Fair, 2., Explainable and transparent, 3. Accountable, 4. Secure and safe, 5. Human-centric and societally beneficial, and 6. Scientifically and technically robust. The framework describes each ethical AI principle, and then applies that principle to NASA work. The framework also includes a list of questions practitioners should use to guide their AI work. Finally, the framework focuses on concrete, practical considerations for the next five - ten years, while also beginning to lay the foundation for longer-term disruptive change as human-level (or beyond) AI is created.

Artificial Intelligence↗
NASA NTRS2002

Autonomous operations through onboard artificial intelligence

The Autonomous Sciencecraft Experiment (ASE) will fly onboard the Air Force TechSat 21 constellation of three spacecraft scheduled for launch in 2006. ASE uses onboard continuous planning, robust task and goal-based execution, model-based mode identification and reconfiguration, and onboard machine learning and pattern recognition to radically increase science return by enabling intelligent downlink selection and autonomous retargeting. Demonstration of these capabilities in a flight environment will open up tremendous new opportunities in planetary science, space physics, and earth science that would be unreachable without this technology.

Autonomous Sciencecraft Experiment ASE TechSat 21↗
NASA NTRS2004

Planning and Execution: The Spirit of Opportunity for Robust Autonomous Systems

One of the most exciting endeavors pursued by human kind is the search for life in the Solar System and the Universe at large. NASA is leading this effort by designing, deploying and operating robotic systems that will reach planets, planet moons, asteroids and comets searching for water, organic building blocks and signs of past or present microbial life. None of these missions will be achievable without substantial advances in.the design, implementation and validation of autonomous control agents. These agents must be capable of robustly controlling a robotic explorer in a hostile environment with very limited or no communication with Earth. The talk focuses on work pursued at the NASA Ames Research center ranging from basic research on algorithm to deployed mission support systems. We will start by discussing how planning and scheduling technology derived from the Remote Agent experiment is being used daily in the operations of the Spirit and Opportunity rovers. Planning and scheduling is also used as the fundamental paradigm at the core of our research in real-time autonomous agents. In particular, we will describe our efforts in the Intelligent Distributed Execution Architecture (IDEA), a multi-agent real-time architecture that exploits artificial intelligence planning as the core reasoning engine of an autonomous agent. We will also describe how the issue of plan robustness at execution can be addressed by novel constraint propagation algorithms capable of giving the tightest exact bounds on resource consumption or all possible executions of a flexible plan.

Muscettola, Nicola↗
NASA NTRS2016

Internship at the Office of the Chief Scientist

The NASA Ames Research Center (ARC) Office of the Chief Scientist (OCS) is part of the Center Management. The OCS adds value to the organization by encouraging and facilitating innovation and value to the Agency, Nation, and the scientific community through its well-developed, diverse, and strategically formed charter. The OCS provides the Center with the oversight and advice by facilitating and evaluating the Scientific Innovation Fund (SIF) and promoting science-based research partnerships. Additionally, the Office contributes to to the Agency by organizing annual Summer Series Colloquia, Workshops, and support to the Early Career Network, which allows for international and inter-agency collaborations. Working at the OCS allowed me to further learn about the working of the Office and how the Office engages and provides guidance with rest of the Center and the Agency. As part of my internship, I am working on developing the initial infrastructure required for the organization of the Standardized Distributed Workshop and further developing the layout for the Hibernation Workshop. The Standardized Distributed System workshop will investigate the scope of developing and using standardized distributed systems for a wide range of applications including satellite systems, aerospace-oriented systems, water-based systems, automobiles, and various other robotics applications. The goal of this workshop is to determine the feasibility of developing a standardized distributed system that can be customized for different technological applications, which will enable resource sharing, openness, robustness, and fault tolerance. This workshop will bring together experts from different fields, including satellite operations, unmanned aerial vehicles, aircraft operation and management, and artificial intelligence to provide a global evaluation of the aspects associated with the development and adoption of distributed systems. The workshop will also guide the participants through state of the art distributed systems, discuss some of the challenges in designing control systems with a distributed structure, and consider the future of distributed system based technologies for future applications. Additionally, I am also working on finalizing the details and documentation for the proposed Hibernation Workshop. This workshop will address the phenomenon of hibernation through three major aspects: hibernation on Earth, hibernation in space, and knowledge gaps in the approaches to future deep space exploration. The primary objective of the workshop is to explore the current state of science in the area of hibernation, and as a scientific community, explore the gaps and challenges preventing this scientific field from advancing to the next level. This workshop will consist of presentations, panel discussions, and breakout sessions focused on addressing this scientific field, and bringing experts from educational and commercial sectors together. As a part of my internship report, I will be document the process of planning these workshops and further provide a brief summary of my experience with the 2016 NASA Ames Summer Series and various professional visits.

ISU↗
NASA NTRS1988

NASA research and development for space telerobotics

The goal of this research is to explore and prove out robust concepts for telerobotic support of space servicing, assembly, maintenance, and telescience tasks. This goal is being addressed through a program of coordinated work in artificial intelligence, robotics, and human factors. The general research objective is the fusion of robot sensing and manipulation, teleoperation, and human and machine cognitive skills into an effective architecture for supervised task automation. NASA is evaluating results of this research program in a ground laboratory telerobot testbed under development at JPL. The testbed development activity includes integrated technology demonstrations. The demonstrations will show telerobot capabilities to perform tasks of increasing complexity, and duration in increasingly unstructured environments. The first such demonstration is the ground-based grappling, dockling, and servicing of a satellite taskboard.

Schenker, Paul S.↗
NASA NTRS2003

Application of Artificial Intelligence Techniques in Unmanned Aerial Vehicle Flight

This paper describes the development of an application of Artificial Intelligence for Unmanned Aerial Vehicle (UAV) control. The project was done as part of the requirements for a class in Artificial Intelligence (AI) at Nova southeastern University and as an adjunct to a project at NASA Goddard Space Flight Center's Wallops Flight Facility for a resilient, robust, and intelligent UAV flight control system. A method is outlined which allows a base level application for applying an AI method, Fuzzy Logic, to aspects of Control Logic for UAV flight. One element of UAV flight, automated altitude hold, has been implemented and preliminary results displayed. A low cost approach was taken using freeware, gnu, software, and demo programs. The focus of this research has been to outline some of the AI techniques used for UAV flight control and discuss some of the tools used to apply AI techniques. The intent is to succeed with the implementation of applying AI techniques to actually control different aspects of the flight of an UAV.

Bauer, Frank H.↗
NASA NTRSDate not supplied

A Systems Approach to AI Model Integration and Performance Evaluation for the Generic UAM Simulation Framework

This paper introduces py-guam, an open-source experimentation framework developed for the NASA Generic Urban Air Mobility simulation (GUAM) environment, facilitating the integration and evaluation of advanced artificial intelligence (AI) algorithms. We present a systems approach which enables the seamless incorporation of data-driven models, including off-nominal and failure state detection, into the GUAM’s Cognitive Architecture (CA). The framework supports customizable experimentation parameters, derives Safety Performance Indicators (SPIs) from UL 4600 safety case analyses, and employs rapid UAM simulations to assess AI impacts on flight performance across diverse scenarios. Through comprehensive testing and validation experiments, we demonstrate GUAM’s capability to enhance safety and efficiency in urban air mobility operations. Additionally, the open-source nature of py-guam fosters community collaboration, ensuring continuous improvement and adaptability to evolving technological advancements. This work establishes a robust tool for developing and testing AI-driven urban air mobility (UAM) systems, advancing the safety and reliability of autonomous urban air vehicles.

Artificial Intelligence↗
NASA NTRS2024

Women’s Health in Spaceflight: Life Beyond Low Earth Orbit

Historically, only 75 women have flown in space and while this inequity has been recently addressed with astronaut candidates about 50% female, research defining female biological responses to spaceflight remain limited. The NASA Artemis Campaign aims to land the first woman on the Moon for purposes of scientific discovery, technology advancement, and learning how to live and work on another world in preparation for human missions to Mars. The need to understand how sex and gender affect a wide range of physiological functions, impacting numerous health outcomes is critical. The purpose of this chapter is to summarize recent findings in women’s health in spaceflight, past studies examining female mammalian responses to spaceflight and highlight the need for additional studies to help reduce risk and enhance countermeasure development specific to female astronauts. The promise of artificial intelligence approaches for advancing the pace of research is discussed with the caveat that, at present, fundamental research on women’s health in space and sex-specificity of response to spaceflight stressors is not sufficiently robust to achieve this goal.

spaceflight↗
NASA NTRS2017

Autonomous, Context-Sensitive, Task Management Systems and Decision Support Tools II: Contextual Constraints and Information Sources

Recent advances in artificial intelligence, machine learning, data mining and sensor technology have resulted in the availability of a vast amount of digital data and information and the development of advanced automated reasoners. This creates the opportunity for the development of a robust dynamic task manager and decision support tool that is context sensitive and integrates information from a wide array of on-board and off aircraft sourcesa tool that monitors systems and the overall flight situation, anticipates information needs, prioritizes tasks appropriately, keeps pilots well informed, and is nimble and able to adapt to changing circumstances. This is the second of two companion reports exploring issues associated with autonomous, context-sensitive, task management and decision support tools. In the first report, we explored fundamental issues associated with the development of such a system. In this report, we extend this work to focus on two critical aspects of these systems: 1) the constraints and conditions that drive the dynamic prioritization and presentation of data and information to the pilots, and 2) specific data and information to be accessed, monitored, integrated, and displayed in such a system.

context-sensitive↗
NASA NTRS2017

Autonomous, Context-Sensitive, Task Management Systems and Decision Support Tools I: Human-Autonomy Teaming Fundamentals and State of the Art

Recent advances in artificial intelligence, machine learning, data mining and extraction, and especially in sensor technology have resulted in the availability of a vast amount of digital data and information and the development of advanced automated reasoners. This creates the opportunity for the development of a robust dynamic task manager and decision support tool that is context sensitive and integrates information from a wide array of on-board and off aircraft sourcesa tool that monitors systems and the overall flight situation, anticipates information needs, prioritizes tasks appropriately, keeps pilots well informed, and is nimble and able to adapt to changing circumstances. This is the first of two companion reports exploring issues associated with autonomous, context-sensitive, task management and decision support tools. In the first report, we explore fundamental issues associated with the development of an integrated, dynamic, flight information and automation management system. We discuss human factors issues pertaining to information automation and review the current state of the art of pilot information management and decision support tools. We also explore how effective human-human team behavior and expectations could be extended to teams involving humans and automation or autonomous systems.

context-sensitive↗