VPHOP
Encyclopedia
VPHOP or the Osteoporotic Virtual Physiological Human is a European osteoporosis
research project within the framework of the Virtual Physiological Human
initiative.
Until August 2012, the VPHOP research project will develop, validate and deploy the next generation of technology to predict the absolute risk of fracture in patients with low bone mass, thereby enabling clinicians to provide better prognoses and implement more effective treatment strategies (both pharmacological and interventional).
Accuracy could be dramatically improved if a more deterministic approach was used which accounts for those factors and their variation between individuals.
The aim of VPHOP is to develop a multiscale modelling technology based on conventional diagnostic imaging methods that makes it possible, in a clinical setting, to predict for each patient the strength of his/her bones, how this strength is likely to change over time, and the probability that the he/she will overload his/her bones during daily life. With these three predictions, the evaluation of the absolute risk of bone fracture will be much more accurate than any prediction based on external and indirect determinants, as is current clinical practice. These predictions will be used to:
For patients at high risk of fracture, and for which the pharmacological treatment appears insufficient, the VPHOP system will also assist the interventional radiologist
in planning the augmentation procedure.
The various modelling technologies developed during the project will be validated not only in vitro, on animal models, or against retrospective clinical outcomes, but will also be assessed in term of clinical impact and safety on small cohorts of patients enrolled at four different clinical institutions, providing the factual basis for effective clinical and industrial exploitation.
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
research project within the framework of the Virtual Physiological Human
Virtual Physiological Human
The Virtual Physiological Human is a methodological and technological framework that, once established, will enable collaborative investigation of the human body as a single complex system...
initiative.
Until August 2012, the VPHOP research project will develop, validate and deploy the next generation of technology to predict the absolute risk of fracture in patients with low bone mass, thereby enabling clinicians to provide better prognoses and implement more effective treatment strategies (both pharmacological and interventional).
Why?
Approximately four million osteoporotic bone fractures cost the European health system more than 30 billion Euro per year. This figure could double by 2050. After the first fracture, the chances of having another one increase by 86%. With current technology osteoporotic fractures can be predicted with an accuracy of 60-70% or less (tossing a coin would give 50%). Better ways to prevent osteoporotic fractures are needed.What?
Current fracture predictions are based on historical, fracture-patient data sets to identify key factors which contribute to the increased probability of an osteoporotic fracture. This approach oversimplifies the mechanisms leading to an osteoporotic fracture and fail to take into account numerous, hierarchical factors which are unique to the individual. These factors span cell-level to body-level functions, i.e.:- Body: Musculoskeletal anatomy and neuromotor control define the daily loading spectrum, including paraphysiological overloading events
- Organ: Fracture events occur at organ level and are influenced by the elasticity and geometry of bone
- Tissue: Bone elasticity and geometry are determined by tissue morphology
- Cell: Cell activity changes tissue morphology and composition over time
- Constituents: Constituents of the extracellular matrix are the prime determinants of tissue strength
Accuracy could be dramatically improved if a more deterministic approach was used which accounts for those factors and their variation between individuals.
How?
By creating a patient-specific hypermodel, a model composed by many sub-models, each describing the relevant phenomena taking place at one of the many dimensional scales involved, this incredibly complex problem may be solved.The aim of VPHOP is to develop a multiscale modelling technology based on conventional diagnostic imaging methods that makes it possible, in a clinical setting, to predict for each patient the strength of his/her bones, how this strength is likely to change over time, and the probability that the he/she will overload his/her bones during daily life. With these three predictions, the evaluation of the absolute risk of bone fracture will be much more accurate than any prediction based on external and indirect determinants, as is current clinical practice. These predictions will be used to:
- Improve the diagnostic accuracy of the current clinical standards;
- Provide the basis for an evidence-based prognosis with respect to the natural evolution of the disease, to pharmacological treatments, and/or to preventive interventional treatments aimed to selectively strengthen particularly weak regions of the skeleton.
For patients at high risk of fracture, and for which the pharmacological treatment appears insufficient, the VPHOP system will also assist the interventional radiologist
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
in planning the augmentation procedure.
The various modelling technologies developed during the project will be validated not only in vitro, on animal models, or against retrospective clinical outcomes, but will also be assessed in term of clinical impact and safety on small cohorts of patients enrolled at four different clinical institutions, providing the factual basis for effective clinical and industrial exploitation.
So what?
VPHOP will realize "P2 medicine" for osteoporosis patients:- Predictive: Multiscale models, representing skeletal mechanobiology, from the whole body down to the molecular constituents, to simulate skeletal loading in various conditions and predict bone failure
- Personalised: The multiscale model is personalised using information which is to the patient. The more information which is available the more personalised becomes the model.
See also
- PhysiomePhysiomeThe physiome of an individual's or species'physiological state is the description of itsfunctional behavior. The physiome describes the physiological dynamics ofthe normal intact organism and is built upon information and...
- PhysiologyPhysiologyPhysiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
- EuroPhysiomeEuroPhysiomeThe Europhysiome initiative is coordinated by the Coordination action, which aims to establish a better coordination between European Physiome projects. The term is also used to indicate collectively all Europe-based Physiome projects such as the [Renal Physiome Project], the [Giome Project], the...
- CytomeCytomeCytomes are the cellular systems, subsystems, and functional components of thebody. The cytome is the collection of the complex and dynamic cellular processes underlying physiological processes. It describes the structural and functional heterogeneity of the cellular diversity of an organism...
- Human anatomyHuman anatomyHuman anatomy is primarily the scientific study of the morphology of the human body. Anatomy is subdivided into gross anatomy and microscopic anatomy. Gross anatomy is the study of anatomical structures that can be seen by the naked eye...
- Living Human ProjectLiving Human ProjectThe Living Human Project is developing a worldwide, distributed repository of anatomo-functional data and of simulation algorithms relative to the human musculoskeletal apparatus, fully integrated into a seamless simulation environment and directly accessible by any researcher in the world...