To review the five NASA evidence reports, the National Academies assembled an 11-member committee with expertise in aerospace medicine, occupational health, clinical care, human performance and human factors, internal medicine, endocrinology, physiology and exercise science, musculoskeletal health, orthopedics, aerospace engineering, otolaryngology, and biomedical informatics. The committee members’ biographical sketches are included in Appendix B.
The committee’s task, detailed in Box 1, was to review each evidence report and provide responses to nine specific questions. In summary, this report examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input. This report builds on the 2008 Institute of Medicine (IOM) report Review of NASA’s Human Research Program Evidence Books: A Letter Report, which assessed the process for developing NASA’s evidence reports and provided an initial and brief review of NASA’s original evidence report.1
The committee approached its task by analyzing each evidence report’s overall quality, which included the report’s readability, its internal consistency, the source and breadth of the evidence it cited, its identification of existing knowledge and research gaps, the expertise of its authors, and, if applicable, the report’s response to recommendations from the 2008 IOM letter report previously described.
The committee again commends NASA for advising report authors to explicitly note the categories of evidence—ranging from expert opinion to data from controlled trials—that were relied on in these reports. This practice is now followed comprehensively in most, although not all, reports; the exceptions are noted in relevant sections below. As noted in pri- or letter reports (IOM, 2014, 2015; NASEM, 2016), substantial variability exists among individual evidence reports in the formatting, internal consistency, and completeness of the references, making it difficult to compare the evidence for related human health risks that is cited in the different reports. NASA is encouraged to select a preferred citation format for all evidence reports and to require all writing teams to use that format.
In addition to analyzing the content of individual letter reports, the committee also gathered evidence from existing literature and relevant experts in the field. The committee held two conference call meetings and one in-person meeting, with the latter held in conjunction with a public workshop (see Appendix A). The committee invited individuals