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NASA NTRS2009

Austere Human Missions to Mars

This slide presentation reviews a possible mission architecture for a more austere Mars mission, than the one developed by NASA outlined in the Design Reference Architecture 5 (DRA 5). "Austere" architecture is scaled back from DRA 5 and might offer lower development cost, lower flight cost, and lower development risk. This approach will not meet all the DRA 5 mission requirements. Included in the presentation are the elements of an Austere mission, diagrams of the trans-Mars injection (TMI), cruise, and Mars Orbital Insertion for various phases of the mission, the entry descent landing (EDL) concept. The key features of the Transit Habitat (TransHab), the Earth Departure Stage (EDS), the landers, are reviewed. A chart shows the Mass in tons, of the conceptual types of Mars Landers. The EDL concept, EDL Phase diagrams for the Mars Lander are reviewed. New technologies that would be required are also reviewed. Flight test programs for the various parts of the architecture and a flight schedule are reviewed.

transit habitat (TransHab)↗
NASA NTRS2009

Austere Human Missions to Mars

The Design Reference Architecture 5 (DRA 5) is the most recent concept developed by NASA to send humans to Mars in the 2030 time frame using Constellation Program elements. DRA 5 is optimized to meet a specific set of requirements that would provide for a robust exploration program to deliver a new six-person crew at each biennial Mars opportunity and provide for power and infrastructure to maintain a highly capable continuing human presence on Mars. This paper examines an alternate architecture that is scaled back from DRA 5 and might offer lower development cost, lower flight cost, and lower development risk. It is recognized that a mission set using this approach would not meet all the current Constellation Mars mission requirements; however, this 'austere' architecture may represent a minimum mission set that would be acceptable from a science and exploration standpoint. The austere approach is driven by a philosophy of minimizing high risk or high cost technology development and maximizing development and production commonality in order to achieve a program that could be sustained in a flat-funded budget environment. Key features that would enable a lower technology implementation are as follows: using a blunt-body entry vehicle having no deployable decelerators, utilizing aerobraking rather than aerocapture for placing the crewed element into low Mars orbit, avoiding the use of liquid hydrogen with its low temperature and large volume issues, using standard bipropellant propulsion for the landers and ascent vehicle, and using radioisotope surface power systems rather than a nuclear reactor or large area deployable solar arrays. Flat funding within the expected NASA budget for a sustained program could be facilitated by alternating cargo and crew launches for the biennial Mars opportunities. This would result in two assembled vehicles leaving Earth orbit for Mars per Mars opportunity. The first opportunity would send two cargo landers to the Mars surface to preposition a habitat, supplies, and exploration equipment. The next opportunity, two years later, would send to Mars orbit 1) a lander with a Mars Ascent Vehicle (MAV) and 2) a crewed Mars Transit Habitat with an Orion CEV for Earth return. The following opportunity, two years after the first crew, would go back to cargo-only launches. This alternation of cargo and crew opportunities results in a sustainable launch rate of six Ares V launches every two years. It is notable that four of the six launches per Mars opportunity are identical, build-to-print, Tran-Mars Injection stages. This type of production rate could lend itself well to a COTStype service provider, and would make it feasible to have a live spare in place in the event of a single launch failure.

landers↗
NASA NTRSDate not supplied

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the intern’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight mid deck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned for dual-use medical scrub and galley handwash facility. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Habitat↗
NASA NTRSDate not supplied

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide NASA’s Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the co-author’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight middeck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned to serve both as a medical scrub facility and for galley hand washing. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Common Habitat↗
NASA NTRS2013

NASA's Space Launch System: Moving Toward the Launch Pad

The National Aeronautics and Space Administration's (NASA's) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center (MSFC), is making progress toward delivering a new capability for human space flight and scientific missions beyond Earth orbit. Designed with the goals of safety, affordability, and sustainability in mind, the SLS rocket will launch the Orion Multi-Purpose Crew Vehicle (MPCV), equipment, supplies, and major science missions for exploration and discovery. Supporting Orion's first autonomous flight to lunar orbit and back in 2017 and its first crewed flight in 2021, the SLS will evolve into the most powerful launch vehicle ever flown via an upgrade approach that will provide building blocks for future space exploration. NASA is working to deliver this new capability in an austere economic climate, a fact that has inspired the SLS team to find innovative solutions to the challenges of designing, developing, fielding, and operating the largest rocket in history. This paper will summarize the planned capabilities of the vehicle, the progress the SLS Program has made in the 2 years since the Agency formally announced its architecture in September 2011, the path it is following to reach the launch pad in 2017 and then to evolve the 70 metric ton (t) initial lift capability to 130-t lift capability after 2021. The paper will explain how, to meet the challenge of a flat funding curve, an architecture was chosen that combines the use and enhancement of legacy systems and technology with strategic new developments that will evolve the launch vehicle's capabilities. This approach reduces the time and cost of delivering the initial 70 t Block 1 vehicle, and reduces the number of parallel development investments required to deliver the evolved 130 t Block 2 vehicle. The paper will outline the milestones the program has already reached, from developmental milestones such as the manufacture of the first flight hardware, to life-cycle milestones such as the vehicle's Preliminary Design Review (PDR). The paper will also discuss the remaining challenges both in delivering the 70-t vehicle and in evolving its capabilities to the 130-t vehicle, and how NASA plans to accomplish these goals. As this paper will explain, SLS is making measurable progress toward becoming a global infrastructure asset for robotic and human scouts of all nations by harnessing business and technological innovations to deliver sustainable solutions for space exploration.

Creech, Stephen D.↗
NASA NTRS2013

NASA's Space Launch System: Moving Toward the Launch Pad

The National Aeronautics and Space Administration's (NASA's) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is making progress toward delivering a new capability for human space flight and scientific missions beyond Earth orbit. Developed with the goals of safety, affordability, and sustainability in mind, the SLS rocket will launch the Orion Multi-Purpose Crew Vehicle (MPCV), equipment, supplies, and major science missions for exploration and discovery. Supporting Orion's first autonomous flight to lunar orbit and back in 2017 and its first crewed flight in 2021, the SLS will evolve into the most powerful launch vehicle ever flown, via an upgrade approach that will provide building blocks for future space exploration and development. NASA is working to develop this new capability in an austere economic climate, a fact which has inspired the SLS team to find innovative solutions to the challenges of designing, developing, fielding, and operating the largest rocket in history. This paper will summarize the planned capabilities of the vehicle, the progress the SLS program has made in the 2 years since the Agency formally announced its architecture in September 2011, and the path the program is following to reach the launch pad in 2017 and then to evolve the 70 metric ton (t) initial lift capability to 130-t lift capability. The paper will explain how, to meet the challenge of a flat funding curve, an architecture was chosen which combines the use and enhancement of legacy systems and technology with strategic new development projects that will evolve the capabilities of the launch vehicle. This approach reduces the time and cost of delivering the initial 70 t Block 1 vehicle, and reduces the number of parallel development investments required to deliver the evolved version of the vehicle. The paper will outline the milestones the program has already reached, from developmental milestones such as the manufacture of the first flight hardware and the record-breaking testing of the J-2X engine, to life-cycle milestones such as the vehicle's Preliminary Design Review. The paper will also discuss the remaining challenges in both delivering the 70 t vehicle and in evolving its capabilities to the 130 t vehicle, and how the program plans to accomplish these goals. As this paper will explain, SLS is making measurable progress toward becoming a global infrastructure asset for robotic and human scouts of all nations by harnessing business and technological innovations to deliver sustainable solutions for space exploration

Creech, Stephen D.↗
NASA NTRS2012

NASA's Space Launch System: A Flagship for Exploration Beyond Earth's Orbit

The National Aeronautics and Space Administration s (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is making progress toward delivering a new capability for exploration beyond Earth orbit in an austere economic climate. This fact drives the SLS team to find innovative solutions to the challenges of designing, developing, fielding, and operating the largest rocket in history. To arrive at the current SLS plan, government and industry experts carefully analyzed hundreds of architecture options and arrived at the one clear solution to stringent requirements for safety, affordability, and sustainability over the decades that the rocket will be in operation. This paper will explore ways to fit this major development within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017. It will explain the SLS Program s long-range plan to keep the budget within bounds, yet evolve the 70 metric ton (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through a competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface over 4 decades ago. Astronauts train for long-duration voyages on the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. NASA is refining its mission manifest, guided by U.S. Space Policy and the Global Exploration Roadmap. Launching the Orion Multi-Purpose Cargo Vehicle s first autonomous certification flight in 2017, followed by a crewed flight in 2021, the SLS will offer a robust way to transport international crews and the air, water, food, and equipment they need for extended trips to asteroids, Lagrange Points, and Mars. In addition, the SLS will accommodate high-priority science experiments. SLS affordability initiatives include streamlining interfaces, applying risk-based insight into contracted work, centralizing systems engineering and integration, and nurturing a learning culture that continually benchmarks its performance against successful ventures. As this paper will explain, the SLS is making measurable progress toward becoming a global infrastructure asset for robotic and human scouts of all nations by harnessing business and technological innovations to deliver sustainable solutions for space exploration.

May, Todd↗
NASA NTRS2012

NASA's Space Launch System: A Flagship for Exploration Beyond Earth's Orbit

The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is making progress toward delivering a new capability for exploration beyond Earth orbit in an austere economic climate. This fact drives the SLS team to find innovative solutions to the challenges of designing, developing, fielding, and operating the largest rocket in history. To arrive at the current SLS plan, government and industry experts carefully analyzed hundreds of architecture options and arrived at the one clear solution to stringent requirements for safety, affordability, and sustainability over the decades that the rocket will be in operation. This paper will explore ways to fit this major development within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017. It will explain the SLS Program s long-range plan to keep the budget within bounds, yet evolve the 70 metric ton (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through a competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface over 4 decades ago. Astronauts train for long-duration voyages on the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. NASA is refining its mission manifest, guided by U.S. Space Policy and the Global Exploration Roadmap. Launching the Orion Multi-Purpose Crew Vehicle s (MPCV s) first autonomous certification flight in 2017, followed by a crewed flight in 2021, the SLS will offer a robust way to transport international crews and the air, water, food, and equipment they need for extended trips to asteroids, Lagrange Points, and Mars. In addition, the SLS will accommodate high-priority science experiments. SLS affordability initiatives include streamlining interfaces, applying risk-based insight into contracted work, centralizing systems engineering and integration, and nurturing a learning culture that continually benchmarks its performance against successful ventures. As this paper will explain, the SLS is making measurable progress toward becoming a global infrastructure asset for robotic and human scouts of all nations by harnessing business and technological innovations to deliver sustainable solutions for space exploration.

May, Todd A.↗
NASA NTRS2022

Turning Limitations into Opportunities in the Development of the Orion Medical System: Incorporation of mHealth Devices

INTRODUCTION: Selection of medical devices for the Orion medical system is a complex task which is dependent on the current state of terrestrial technology. In this work we review the interplay between NASA requirements, constraints, and opportunities for synergy during the development of the Orion medical system. METHODS: The “plan to treat” list of conditions, and subsequently the medical resource list for the Orion Artemis II lunar flyby mission was completed using semi-quantitative methods. During this process, some medical resources were excluded to comply with mass and volume limits, while other resources applicable to multiple medical requirements were prioritized for inclusion. Choices were also examined considering NASA level of care standards for the Artemis design reference missions. As a means to optimize capabilities in spite of mass and volume constraints, ideas for integration of multiple devices into a single platform were explored, including a ‘hackathon’ challenge which was conducted to generate and evaluate concepts for combining medical devices into a single app-based mobile device (ultrasound, ECG, etc.). RESULTS: The Orion team identified 128 medical conditions that we “plan to treat”, with 139 unique medical resources to address these conditions, including 5 digital diagnostic devices (ECG, otoscope, stethoscope, pulse oximeter, and blood pressure monitor). During selection of these digital devices the team noted that miniaturized medical devices often use mobile device platforms (mHealth), some displaying and transmitting data exclusively via mobile device. Of the 5 initially selected devices, all are capable of mobile connection, one which cannot function without a mobile device (ECG). Furthermore, only one of these devices connects natively to a Windows platform, which is currently the only operating system available on Orion. DISCUSSION: Significant savings in mass and volume as well as training and usability improvements can be achieved by leveraging mHealth technologies. However, the platform presents significant challenges for deployment within the Artemis Program including lack of internet connectivity, incompatible operating systems, and radiation concerns. Each of these drawbacks are surmountable with investment in the supporting vehicle architecture, which may become necessary to support the technology trends seen in commercially available medical devices today. Objective: Learn about the opportunities and challenges of leveraging mHealth devices in the development of medical capabilities for austere environments. Learn about the constraints of the NASA spaceflight environment with regards to digital medical device integration.

Douglas Ebert↗
NASA NTRS2007

An Evidence-based Approach to Developing a Management Strategy for Medical Contingencies on the Lunar Surface: The NASA/Haughton-Mars Project (HMP) 2006 Lunar Medical Contingency Simulation at Devon Island

The lunar architecture for future sortie and outpost missions will require humans to serve on the lunar surface considerably longer than the Apollo moon missions. Although the Apollo crewmembers sustained few injuries during their brief lunar surface activity, injuries did occur and are a concern for the longer lunar stays. Interestingly, lunar medical contingency plans were not developed during Apollo. In order to develop an evidence-base for handling a medical contingency on the lunar surface, a simulation using the moon-Mars analog environment at Devon Island, Nunavut, high Canadian Arctic was conducted. Objectives of this study included developing an effective management strategy for dealing with an incapacitated crewmember on the lunar surface, establishing audio/visual and biomedical data connectivity to multiple centers, testing rescue/extraction hardware and procedures, and evaluating in suit increased oxygen consumption. Methods: A review of the Apollo lunar surface activities and personal communications with Apollo lunar crewmembers provided the knowledge base of plausible scenarios that could potentially injure an astronaut during a lunar extravehicular activity (EVA). Objectives were established to demonstrate stabilization and transfer of an injured crewmember and communication with ground controllers at multiple mission control centers. Results: The project objectives were successfully achieved during the simulation. Among these objectives were extraction from a sloped terrain by a two-member crew in a 1 g analog environment, establishing real-time communication to multiple centers, providing biomedical data to flight controllers and crewmembers, and establishing a medical diagnosis and treatment plan from a remote site. Discussion: The simulation provided evidence for the types of equipment and methods for performing extraction of an injured crewmember from a sloped terrain. Additionally, the necessary communications infrastructure to connect multiple centers worldwide was established from a remote site. The surface crewmembers were confronted with a number of unexpected scenarios including environmental, communications, EVA suit, and navigation challenges during the course of the simulation which provided insight into the challenges of carrying out a medical contingency in an austere environment. The knowledge gained from completing the objectives will be incorporated into the exploration medical requirements involving an incapacitated astronaut on the lunar surface.

Scheuring, R. A.↗
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↗