Aerosp Med Hum Perform. 2020 Apr 1;91(4):332-342. doi: 10.3357/AMHP.5432.2020.
The Integrated Medical Model (IMM) is a quantified, evidence-based decision support tool developed by National Aeronautics and Space Administration (NASA) to assist in the assessment of the medical risk of human spaceflight missions. The IMM utilizes a probabilistic risk assessment (PRA) approach to simulate potential in-flight medical events and resultant health and mission outcomes. The IMM has been utilized to estimate the medical risk associated with International Space Station (ISS) missions. The IMM outputs that have been most informative to the ISS program are the probabilities of evacuation (pEVAC) and loss of crew life (pLOCL). These outputs are incorporated into a continuously maintained ISS PRA model so that its quantification of total ISS mission risk includes the medical risk. Results of this analysis revealed that the forecasted risk values of pEVAC and pLOCL due to medical events were improved by using the IMM with the ISS PRA model instead of using data from prior sources in which these values were underestimated. The IMM provides an evidence-based PRA approach to directly communicate and integrate medical risk with other ISS risks. A comparison of IMM outputs of pEVAC and pLOCL to empirical spaceflight data and analog population data revealed that IMM outputs were comparable with actual experience. With appropriate outcome context, these findings increase subject matter expert confidence in the accuracy of IMM risk estimates. IMM outputs provide quantifiable objective estimates of medical risk that can be used to inform mission risk assessments and to optimize crew health.
综合医学模型（IMM）是一种经过量化、基于证据的决策支持工具，由美国国家航空航天局（NASA）开发，用于评估人类太空飞行任务的医疗风险。IMM 采用概率风险评估（PRA）方法来模拟潜在的飞行中医疗事件以及由此产生的健康和任务结果。IMM 已被用于估计国际空间站（ISS）任务相关的医疗风险。对 ISS 计划最具信息性的 IMM 输出是撤离概率（pEVAC）和船员生命损失概率（pLOCL）。这些输出被纳入一个持续维护的 ISS PRA 模型中，以便其对总 ISS 任务风险的量化包括医疗风险。该分析的结果表明，由于医疗事件，pEVAC 和 pLOCL 的预测风险值通过使用 IMM 与 ISS PRA 模型而不是使用这些值被低估的先前来源的数据来改进。IMM 提供了一种基于证据的 PRA 方法，可直接与其他 ISS 风险沟通并整合医疗风险。对 pEVAC 和 pLOCL 的 IMM 输出与实证太空飞行数据和模拟人群数据进行比较表明，IMM 输出与实际经验相当。在适当的结果背景下，这些发现增加了主题专家对 IMM 风险估计准确性的信心。IMM 输出提供了可量化的医疗风险客观估计，可以用于告知任务风险评估和优化船员健康。
