Clinical risk management approach for long-duration space missions.

Area of Science:

• Aerospace Medicine
• Spaceflight Physiology
• Medical Standards Evaluation

Background:

• The International Space Station (ISS) Multilateral Space Medicine Board (MSMB) faces diverse medical issues in crew evaluation for long-duration missions.
• Some conditions fall outside established ISS Medical Standards, requiring special consideration.

Purpose of the Study:

• To develop an objective, evidence-based risk assessment method for evaluating crewmembers with non-standard medical conditions.
• To inform aeromedical disposition decisions for International Space Station (ISS) missions.

Main Methods:

• A 4x4 risk matrix was developed to plot the probability of an event against its potential impact.
• Event probability was determined through comprehensive reviews of clinical and aerospace literature.
• Event impact (consequences) was systematically assessed and assigned within the matrix.

Main Results:

• The risk matrix approach refined case assessments using evidence-based data and risk stratification.
• Objective risk evaluation has led to the recertification of some crewmembers with previously disqualifying medical conditions.
• The process enhances the International Space Station (ISS) Multilateral Space Medicine Board (MSMB) case assessment.

Conclusions:

• The described risk matrix approach facilitates objective, evidence-based disposition decisions for the MSMB.
• This methodology is broadly applicable within the aerospace medicine community for evaluating crew health.
• It supports informed decision-making for long-duration spaceflight crew certification.