Life Sciences in the Space Program 



management system also increases. Studies conducted under a JSC contract to 

 define the epidemiological^ expected disease/event morbidity rates affecting Space 

 Station crew members have shown that the most valid sources of data are the 

 astronaut inflight and ground-based medical records (4). For Operational Medicine 

 to make informed decisions, complete and up-to-date medical information should 

 be readily available in an appropriately encoded fashion to maintain confiden- 

 tiality. The effects of repeated and prolonged exposures to microgravity and the 

 particular radiation environment for an individual crew member, for example, will 

 need to be evaluated with an adaptable and conveniently accessible information 

 management system. The data should be available to the NASA life sciences 

 community through the information system and, since this data base is a national 

 resource, to all life sciences investigators through appropriate arrangements. The 

 information management system should be flexible enough to allow for real-time 

 data entry during missions. This would make trend analysis of physiologic 

 parameters possible during prolonged missions on a group or individual basis. 

 Useful information may become available in this fashion that could assist in the 

 development of individualized countermeasures to combat the negative 

 physiological effects of microgravity. 



There is room for significant progress in development of a computer-assisted 

 medical decision-making system to supplement the HMF. A microprocessor-based 

 "free text decision support system" as developed under KSC direction is a notable 

 start (5). Also, the work NASA has supported at the University of Maryland to 

 investigate a "computer-based noninvasive physiologic evaluation system" 

 represents significant progress in this area (6). An interactive, intelligent system 

 should eventually be tied into the life sciences medical data-base management 

 svstem to be updated in real time, so that the most up-to-date information is 

 available for decision making. 



Space Medicine Specialist Training 



The inclusion of a physician on board to maintain and monitor crew health, 

 diagnose and treat medical problems, and collect medical data will be justified as 

 missions lengthen and crew sizes enlarge. Operational Medicine should define the 

 baseline requirements and determine the educational credentials and training 

 necessary for this medical specialist. While receiving NASA training, the physician 

 could maintain clinical expertise bv attending medical conferences and, more 

 importantly, by proceeding through a designated number and type of hospital- 

 and/or clinic-based training/refresher programs involving direct patient care. The 

 particular distribution of specialty rotations should be determined by Operational 

 Medicine based upon the individual's background, interests, and NASA's planned 

 missions. At present, however, a program does not exist for training uvu 

 physicians. 



Programmatic Issues in Support of 

 Advanced Manned Missions 



Operational Medicine must identify the programmatic changes necessary to 



support long-duration missions staffed by relatively large and heterogeneous 



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