Autonomous Medical Response Agent (AMRA) for Prolonged Field Care in Space

Prolonged Field Care (PFC) is utilized by the US Military to delivernbsp;field medical care beyond planned timelines of evacuation in order to decrease patient mortality and morbidity. PFC utilizes limited resources tonbsp;sustain carenbsp;until the patient arrives atnbsp;the nextnbsp;level of care. nbsp;Life-threatening medical conditions requiringnbsp;evacuation, pose a significant risk of loss of life and mission for long duration exploration missionsnbsp;nbsp;Astronaut crews evacuating to earthnbsp;willnbsp;deliver prolonged field carenbsp;without real-time decision support.nbsp;NASA will need to nbsp;nbsp;develop prolonged field care protocols that incorporate autonomous decision support.nbsp;Nahlia Inc demonstrated an Autonomous Medical Response Agent (AMRA) in previousnbsp;research efforts.nbsp;AMRA is a multi-criteria feedback control Bayesian clinical decision support tool. Clinical history, physical exam, laboratory and imaging assessments, vehicle and environmental data are combined. Calculated post-test likelihood distributions ofnbsp;disease, clinical andnbsp;missionnbsp;outcomesnbsp;(Med09)nbsp;guide thenbsp;sequence ofnbsp;evidence-based protocols. Inventory and astronaut personal preference (Med03) filter choices and just-in-time training provides point-of-care instruction to CMO#39;s.nbsp;Outcomes measuresnbsp;provide anbsp;multi-organ system state estimate of health andnbsp;contributes tonbsp;an estimated risk posture for crew and mission (Med08, Med09).nbsp;nbsp;Differences between current and goal health state, defined by NASA STD3001,nbsp;sustain AMRAs guidance until a goal state is achieved.nbsp;nbsp;AMRAnbsp;sends informationnbsp;to Mission Control,nbsp;coordinatingnbsp;asynchronous care (HARI02).nbsp;The proposal seeksnbsp;to establish thenbsp;benefitsnbsp;and feasibility of a systematic capability to develop, guide, and train PFC protocols fornbsp;space. Tasks includenbsp;(1)systematic approach tonbsp;evidence-basednbsp;autonomous PFC protocolsnbsp;nbsp;(2) Clinical Case Simulator to testnbsp;PFC protocols,nbsp;(3)nbsp;Mission Coordinatornbsp;to facilitate collaboration with Mission control 4)nbsp;Case-Based Trainer to prepare Astronautsnbsp;for PFC in Space.nbsp;