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

In previous TRISH and NASA funded efforts, Nahlia has developed nested logic, Bayesian algorithms and software, to dynamically analyze and deliver evidence based clinical decision support to control evolving medical situations. This Autonomous Medical Response Agent (AMRA) was further advanced in phase I SBIR based on military Prolonged Field Care principles for autonomous field medical care. AMRA provides coordinated mission guidance for multiple caregivers, a clinical case simulator to systematically and verifiably improve AMRAs decision structure, and an integrated clinical case-based training feature to maintain optimal human-machine performance for autonomous medical operations. Phase II work focuses on expanding AMRAs probabilistic structure to includeparallel feedback control, Bayesian nested hidden state networks capable of providing resource constrained clinical decision support to optimize the health state of Astronauts. Learning and path optimization algorithms in AMRA will extend longevity and usability of AMRA.The efficacy andvalidity of AMRA will be demonstrated with an experienced NASA Flight Surgeon and non-clinician astronaut-like users at the Naval Post Graduate School. Astronauts on long duration missions may suffer medical conditions requiring rapid intervention. Distance to earth will not allow real-time telemedical support, resupply, or evacuation. Autonomous clinical decision support is required. This proposal advances an Autonomous Medical Response Agent (AMRA) for three medical conditions: difficulty breathing, abdominal pain, and altered mental status. A crew caregiver reports findings to AMRA's input GUI. Bayesian diagnosis and treatment engines feedback to AMRA's hidden state estimator and initiate management protocols. Dynamic mission constraints focus AMRA's Mission Coordinator to schedule a minimum cost path of protocols to ameliorate astronaut impairment. A Caregiver GUI provides guidance to perform chosen diagnostics and treatments. Feedback of clinical outcomes informs continued autonomous guidance.   AMRA's efficacy, usability and validity will be assessed with astronaut-like users at the Naval Postgraduate School. A software prototype of the system developed under the proposed work will be delivered to NASA.  The central objectives of the Phase II proposal are to develop and assess the performance of an adaptable Autonomous Medical Response Agent platform composed of dynamic Bayesian nested graphs and feedback control, capable of learning from clinical experience, and enable resource constrained autonomous medical operations on Exploration Class Mission simulations.   Specific Phase II objectives are: Comprehensive Models of Complex Medical Conditions for Spaceflight Dynamic Bayesian Nested Graphs for Complex Medical Conditions Formulate Feedback Control for Dynamic Bayesian Nested Graphs Learning in Parameterized Bayesian Nested Graphs for Complex Medical Conditions Resource constrained Path Optimization for Autonomous Medical Operations Performance Assessment of Autonomous Medical Response Agent Software The Autonomous Medical Response Agent prototype software implementation and documentation will be delivered to NASA at the end of Phase II.

Autonomous Medical Response Agent addresses multiple NASA HRP Gaps: Medical-101,201, 301, 401,601,701 Remote field applications to assist flight surgeons on HISEAS, or McMurdo Station Autonomous medical response system has the potential to aid astronauts on long duration missions to the Moon and Mars.   DoD: Prolonged field care practitioners, Undersea Submarine Medical Caregivers, Air Force pararescue Civilian: aeromedical evacuation, rural/indigenous peoples care, international disaster relief, prison health systems Commercial: Assist nurse practitioners and physician assistants, health insurance to predict costs of care      

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