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The document summarizes limited spaceflight evidence, USAF aviator analog data, and general population terrestrial rates, then presents a Bayesian posterior incidence rate with Gamma distribution parameters and confidence 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is the clinical risk described for sudden cardiac arrest in SCA?","Question",{"text":63,"@type":64},"SCA is described as the heart suddenly and unexpectedly stopping, which stops blood flow to the brain and other vital organs, risking severe irreversible damage in as little as 4 minutes if not restored.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does the incidence model draw input data for calculations?",{"text":68,"@type":64},"The model imports incidence information from the MEDPRAT Evidence Library Database, including incidence data category, space adaptation status, EVA status, incidence data type, and distribution/characteristic information used to randomly select incidence and occurrence values per crewmember.",{"name":70,"@type":61,"acceptedAnswer":71},"What is the Bayesian posterior distribution reported for the incidence rate?",{"text":72,"@type":64},"Under an uninformative prior, the Bayesian posterior is a Gamma distribution with shape=7.743 and rate=162158.2, 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heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs putting them at risk of severe , irreversible damage in as little as 4 minutes if blood flow is not restored (Maron , 2009) . In the context of spaceflight with NASA astronauts, who are heavily screened prior to flight , this condition is most likely to occur as a result of an electrical shock or asthe end state of one of the other included conditions capable of affecting heart and lung function.  \nINCIDENCE DATAINCLUDED IN THE MODEL  \nThe model imports the following incidence information from the MEDPRAT Evidence Library Database: incidence data category, space adaption status, EVA status, incidence data type , incidence and occurrence distribution data and incidence data characteristics. Data category defines the type of data available for incidence calculations (i.e. raw data vs. adjusted data) . Space adaptation identifies medical events that where onset occurs in the first 5-7 days of flight and does not reoccur. EVA-related incidence values identify medical events that occur only during an EVA. Incidence values types vary by data category and define the number of medical events per person-year (rates) or medical events per person at-risk (proportion) for each medical condition. Incidence values can be modified by crew characteristics such as gender sex and certain crew medical history characteristics. Modifying characteristics are noted below and incidence values are listed individually for each characteristic. Distributions are assigned to medical events incidence values and occurrences in the model. For each crewmember in a given trial, the incidence and number of occurrences of each medical condition are randomly selected from these probability distributions. Detailed descriptions of the distributions are included in the MEDPRAT Technical Description Document.  \nINCIDENCE DATA  \nSPACEFLIGHT LITERATURE  \nData is limited regarding general cardiac events in space to generate prediction of incidence. However , to date , no astronaut has experienced an SCA or myocardial infarction (MI) in space or in follow up totaling 4 ,435 person-years (HSRB CR SA-03267) . For arrythmias that could potentially lead to SCA, there is data to suggest the incidence is 0%. Hastings, 2018 followed twelve astronauts with Holter monitors at several points in and around their missions: two preflight; in-Flight Day (FD)-14 , 30 , 75 , 135; 15 days prior to return; and immediately upon landing. No evidence of sustained VT or any other arrythmia that would be concerning to cause SCA was identified. These data strongly support that long duration spaceflight is not associated with changes in arrhythmia frequency or arrhythmic substrate among astronauts (Hastings, 2018) . This suggests that astronauts are no more likely to experience SCA than a similar age and health matched terrestrial population.  \nANALOGLITERATURE  \nIn a review of USAF active duty air crew aged 31-53 (average age 44 years) over a 5-year period , 8 out of the total 165 ,209 people experienced sudden cardiac death (SCD) (Osswald , 1996) yielding an annual rate of 1 sudden cardiac death in 100 ,000 for this analogue population of health near astronaut age individuals. This study did not capture the rate of sudden cardiac arrest (SCA) and included markedly few women; however , since SCA is likely more common than SCD and there is strong evidence that being female is protective for SCD (Risgard , 2014 , Messner , 2003 , Mozaffarian , 2015) this estimation is likely within the ballpark of actual risk. This is also supported by the absence of significant evidence for SCA or dangerous arrythmias in the spaceflight literature (HSRB CR SA-03267) .  \nTERRESTRIAL LITERATURE  \nRisgard , 2014 , Messner , 2003 , and Mozaffarian , 2015 provide general population data. This is expecte","cbCaiuxhjVhNbSb9","https://ap.wps.com/l/cbCaiuxhjVhNbSb9","pdf",335111,14,"English","# INCIDENCE DATA\n## INCIDENCE DATA INCLUDED IN THE MODEL\n## INCIDENCE DATA\n### SPACEFLIGHT LITERATURE\n### ANALOG LITERATURE\n### TERRESTRIAL LITERATURE\n## OVERALL INCIDENCE SUMMARY\n## TABLE1: INCIDENCE MODEL\n## TABLE2: INCIDENCE LEVEL OF CONFIDENCE (LOC)","[{\"question\":\"What is the clinical risk described for sudden cardiac arrest in SCA?\",\"answer\":\"SCA is described as the heart suddenly and unexpectedly stopping, which stops blood flow to the brain and other vital organs, risking severe irreversible damage in as little as 4 minutes if not restored.\"},{\"question\":\"How does the incidence model draw input data for calculations?\",\"answer\":\"The model imports incidence information from the MEDPRAT Evidence Library Database, including incidence data category, space adaptation status, EVA status, incidence data type, and distribution/characteristic information used to randomly select incidence and occurrence values per crewmember.\"},{\"question\":\"What is the Bayesian posterior distribution reported for the incidence rate?\",\"answer\":\"Under an uninformative prior, the Bayesian posterior is a Gamma distribution with shape=7.743 and rate=162158.2, reporting a mean of 4.775E-5 and SD of 1.716E-5.\"}]","ICL106 - Sudden Cardiac Arrest - Clinical Finding Form | PDF",1790508937,35]