Watching without Seeing: A Tool to Surveil Astronaut Health Outcomes While Maintaining Astronaut Medical Privacy
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Engineering topics
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As NASA transitions its focus to travel back to the moon and on to new destinations, the need to ensure the capture, analysis, and application of research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP), based at NASA’s Johnson Space Center (JSC), recognizes the need to extract the greatest possible amount of information from the data already captured. To this end, the HRP Chief Scientist Office (CSO), HRP Program Planning and Control (PP&C) Office, and the Space Medicine Operations Division have been working together to make reuse of both research data and medical monitoring data more accessible to the user community through the Life Science Data Archive (LSDA) and the Lifetime Surveillance of Astronaut Health (LSAH) Repositories. The task of both LSDA and LSAH repositories is to acquire, preserve, and distribute retrospective research (LSDA) and medical (LSAH) data and information both within the NASA community and to the science community at large, for knowledge discovery, retrospective analysis, and planning of future research studies. An additional goal is to encourage collaboration with non-NASA institutions also faced with enhancing human performance in extreme environments. In September 2022, the LSDA website and its contents transitioned to a new NASA Life Sciences Portal (https://nlsp.nasa.gov/explore/lsdahome). This site continues to feature publicly releasable information such as non-attributable datasets, experiment descriptions (from Project Mercury to ISS, as well as from multiple flight analog missions), descriptions of medical monitoring data, and LSAH newsletters (1992 - 2022). The website also provides an updated portal to request additional research and medical data not accessible from the public website. This presentation will provide an in-depth look at the new system as it relates to finding and requesting retrospective data. We will also detail processes from making a request to delivering data for different types of data requests (i.e., attributable, or non-attributable). This includes descriptions of various approval boards, what information and actions the requestor is responsible for, and key milestones in making data available for reuse.
- The Human System Risk Board (HSRB) is responsible for the management of a portfolio of 30 human system risks that NASA tracks and configuration manages to mitigate for future crewed exploration missions. - The HSRB has been exploring the concept of causal diagrams (in the form of Directed Acyclic Graphs or DAGs) as an approach to creating knowledge graphs for each risk to enable shared mental models of causal flow from spaceflight hazards to mission outcomes among HSRB Stakeholders. - These diagrams are intended to improve insight and communication of risk across the myriad subject matter experts and management interested in human system risk reduction. This includes program managers, systems engineers, and operators in addition to the Human Health and Performance Directorate. - The DAG project was intended to create the foundation for composition of the 30 baselined DAGs into a single risk network and software is being developed in parallel to enable this forward work.
INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.