Osteoporotic Virtual Physiological Human
VPHOP or the Osteoporotic Virtual Physiological Human is a European osteoporosis research project within the framework of the Virtual Physiological Human initiative. Osteoporotic fractures. 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. Fracture predictions. 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. Musculoskeletal anatomy and neuromotor control define the daily loading spectrum, including paraphysiological overloading events. Fracture events occur at organ level and are influenced by the elasticity and geometry of bone Bone elasticity and geometry are determined by tissue morphology. Cell activity changes tissue morphology and composition over time. 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. Hypermodel. 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. 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. Osteoporotic Virtual Physiological Human