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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↗

Sensitivity Analysis of the Integrated Medical Model for ISS Programs

Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral part of the overall verification, validation, and credibility review of IMM v4.0.

medical equipment↗

Optimization Routine for Generating Medical Kits for Spaceflight Using the Integrated Medical Model

The Integrated Medical Model (IMM) is a MATLAB model that provides probabilistic assessment of the medical risk associated with human spaceflight missions.Different simulations or profiles can be run in which input conditions regarding both mission characteristics and crew characteristics may vary. For each simulation, the IMM records the total medical events that occur and “treats” each event with resources drawn from import scripts. IMM outputs include Total Medical Events (TME), Crew Health Index (CHI), probability of Evacuation (pEVAC), and probability of Loss of Crew Life (pLOCL).The Crew Health Index is determined by the amount of quality time lost (QTL). Previously, an optimization code was implemented in order to efficiently generate medical kits. The kits were optimized to have the greatest benefit possible, given amass and/or volume constraint. A 6-crew, 14-day lunar mission was chosen for the simulation and run through the IMM for 100,000 trials. A built-in MATLAB solver, mixed-integer linear programming, was used for the optimization routine. Kits were generated in 10% increments ranging from 10%-100% of the benefit constraints. Conditions wheremass alone was minimized, volume alone was minimized, and where mass and volume were minimizedjointly were tested.

Medical Kit↗

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

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

Leinweber, Lawrence↗