Since illnesses and injury during space flight pose risks both to crew health and to mission objectives during Space Exploration, these risks must be minimized in multiple ways (e.g., selection criteria, preventative measures, flying appropriate hardware, and procedures). Under this task, the principal investigator produced a software-based decision support tool using an evidence-based approach to delineate clinical strategies for minimizing risks to crew health during space missions. The Integrated Medical Model (IMM) is designed to identify and quantify crew health risks during flight and to evaluate the effectiveness of in-flight mitigation strategies. The IMM integrates terrestrial and space flight evidence bases to quantify the probability and the consequences of in-flight medical risks using Monte Carlo simulations. Utilizing well accepted scenario driven techniques, such as probabilistic risk analysis, as a guide, IMM generates a set of quantitative measures, such as mission time lost, probability of crew evacuation, and probability of loss of crew life, to enable decision makers to make objective assessment of crew health and mission outcomes with respect to our current level of knowledge. The current IMM can be used to optimize in-flight medical system capabilities, manage science and technology development portfolios, prioritize crew medical training, and support a variety of “what if” scenarios posed by mission planners. The latest version of the model, IMM 3.0, includes a SQL database and Reference Manager central library, which quantify and document all the clinical evidence used by the IMM. This interdisciplinary research effort included the establishment of a conceptual framework, the development of an extensive input dataset and SQL database, the development of external models, the creation of simulation and optimization model software, and the design and implementation of novel verification, validation, and configuration management processes. OBJECTIVES The IMM Project was tasked to develop an evidence-based, probabilistic decision support tool and integrate the tool in the decision making processes of customers within the Space Life Sciences Directorate (SLSD). The five key objectives of the IMM Project support these overarching goals: 1) develop a software-based, stochastic decision support tool useful to clinical stakeholders and medical mission planners; 2) develop a knowledge management tool for the clinical evidence used by the model; 3) update the medical risk estimates of the Probabalistic Risk Assessment model used by the International Space Station (ISS) Program; 4) develop the ability to optimize the mass and volume for an in-flight medical system and specified level of risk; and 5) help close the communication gaps among science, clinical operations, and engineering communities.