The ANTIDOTE Institute - Advancing New Toxicology Investigators in Drug Abuse and Original Translational Research Efforts

The Artemis program's pursuit of deep space missions, including Mars exploration, necessitates increasingly Earth-independent medical care. As crewed missions grow in duration and distance, challenges in communication, resupply, and evacuation compound the risk of medical emergencies. Toxicologic exposures such chemical exposures and medication overdoses are among the high-priority concerns identified by NASA for such missions. This project proposes the development of a Clinical Decision Support System (CDSS) to aid in the autonomous management of toxicologic emergencies in space. The project consists of three aims: (1) a scoping review of toxicologic hazards in spaceflight environments to consolidate existing knowledge and identify critical threats, including inhalational toxins and medication-related events; (2) a Delphi panel of 12–20 experts in space medicine, toxicology, and clinical support to achieve consensus on the most relevant toxicologic emergencies warranting CDSS development; and (3) creation and usability testing of an initial CDSS prototype using medical simulations involving astronaut-like participants. Performance will be evaluated with structured rubrics, while participant feedback will inform further system refinement. Led by Dr. Bryan Wilson, an emergency physician, toxicologist, and flight surgeon, in collaboration with Dr. Roger Dias, an expert in medical simulation and human factors, the project is grounded in aerospace medical expertise. The findings and tools developed here will support the Human Research Roadmap goals related to inflight medical capabilities and human-systems integration for autonomous missions. This work not only advances space medicine but offers terrestrial benefit by informing toxicologic care in austere or underserved environments. Insights from this project may enhance poison center capabilities, inform non-expert responders, and aid substance use treatment in resource-limited settings. Results will be disseminated through national meetings and peer-reviewed publication to advance both aerospace and clinical toxicology.