title: Concept of Operations Evaluation for Using Remote-Guidance Ultrasound for Exploration Spaceflight.
abstract: BACKGROUND
  Remote-guidance (RG) techniques aboard the International Space Station (ISS) have enabled astronauts to collect diagnostic-level ultrasound (US) images. Exploration-class missions will likely require nonformally trained sonographers to operate with greater autonomy given longer communication delays (> 6 s for missions beyond the Moon) and blackouts. Training requirements for autonomous collection of US images by non-US experts are being determined.
  
  
  METHODS
  Novice US operators were randomly assigned to one of three groups to collect standardized US images while drawing expertise from A) RG only, B) a computer training tool only, or C) both RG and a computer training tool. Images were assessed for quality and examination duration. All operators were given a 10-min standardized generic training session in US scanning. The imaging task included: 1) bone fracture assessment in a phantom and 2) Focused Assessment with Sonography in Trauma (FAST) examination in a healthy volunteer. A human factors questionnaire was also completed.
  
  
  RESULTS
  Mean time for group B during FAST was shorter (20.4 vs. 22.7 min) than time for the other groups. Image quality scoring was lower than in groups A or C, but all groups produced images of acceptable diagnostic quality.
  
  
  CONCLUSIONS
  RG produces US images of higher quality than those produced with only computer-based instruction. Extended communication delays in exploration missions will eliminate the option of real-time guidance, thus requiring autonomous operation. The computer program used appears effective and could be a model for future digital US expertise banks. Terrestrially, it also provides adequate self-training and mentoring mechanisms.
authors.affiliation: Crew Health and Research, Wyle Science, Technology and Engineering, Houston, TX, USA.
authors.forename: Victor W
authors.initials: VW
authors.lastname: Hurst
authors.forename: Sean
authors.initials: S
authors.lastname: Peterson
authors.forename: Kathleen
authors.initials: K
authors.lastname: Garcia
authors.forename: Douglas
authors.initials: D
authors.lastname: Ebert
authors.forename: David
authors.initials: D
authors.lastname: Ham
authors.forename: David
authors.initials: D
authors.lastname: Amponsah
authors.forename: Scott
authors.initials: S
authors.lastname: Dulchavsky
mesh_terms: D000328:Adult; D000337:Aerospace Medicine / Q000379:methods*; D003194:Computer-Assisted Instruction / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D013026:Space Flight; D017216:Telemedicine / Q000379:methods*; D014463:Ultrasonography / Q000295:instrumentation / Q000592:standards*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging