MedSurf is located in Honolulu, Hawaii and strives to deliver medical treatment management tools to physicians via the Internet. The U.S. Food and Drug Administration has authorized our medical treatment management tool for osteoporosis (RLFP) for use on the Internet.

Remaining Lifetime fracture risk reporting was developed by Dr. Richard Wasnich and his colleagues at the Hawaii Osteoporosis Study, an 18 year longitudinal study of men and women in Honolulu, HI. The RLFP system was designed to allow physicians to better interpret bone density scans by converting to absolute (as opposed to relative) fracture risk, and by also incorporating other, important risk factors for fracture, including prior, non-violent fractures, age, bone loss rate (either measured or estimated), and, for long term risk estimates, life expectancy. The report is based on 20 years of research and data described in the references below.

REFERENCES

1.                    Ross PD, Wasnich RD, MacLean CJ, Vogel JM.  Prediction of individual lifetime fracture expectancy using bone mineral measurements.  In:  Osteoporosis 1987.  C Christiansen, JS Johansen, BJ Riis (eds).  Osteopress, Copenhagen, Denmark, 1987, pp 288-293.

 

2.                    Ross PD, Wasnich RD, MacLean CJ, Hagino R, Vogel JM.  A model for estimating the potential costs and savings of osteoporosis prevention strategies.  Bone 9:337-347, 1988.

 

 

3.                    Davis JW, Vogel JM, Ross PD, Wasnich RD.  Disease versus etiology: the distinction should not be lost in the analysis.  J Nucl Med 30:1273-1276, 1989

 

4.                    Wasnich RD, Ross PD, Vogel JM, Davis JW.  Osteoporosis.  Critique and Practicum.  Banyan Press, Honolulu, 1989.

 

5.                    Ross PD, Davis JW, Wasnich RD.  An analysis of fracture risk.  J Bone Miner Res, 1990, 5:419-20.

 

6.                    Wasnich RD, Ross PD, Davis JW. Osteoporosis: Current practice and future perspectives. Trends Endocrinol Metab 2:59-62, 1991.

 

7.                    Ross PD, Wasnich RD, Davis JW. Fracture prediction models for osteoporosis prevention. Bone 11:327-331, 1990.

 

8.                    Ross PD, Davis JW, Wasnich RD, Vogel JM. Optimizing treatment regimens for preventing osteoporosis. In:  Osteoporosis 1990.  C Christiansen, K Overgaard (eds).  Osteopress ApS, Copenhagen, Denmark, 1990, pp1096-8.

 

9.                    Ross PD, Davis JW, Epstein R, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women.  Ann Intern Med 114(11):919-923, 1991.

 

10.                 Consensus Development Conference. Prophylaxis and treatment of osteoporosis. Osteoporosis Int 1(2):114-7, 1991.

 

11.                 Wasnich RD.  Bone mass measurements in diagnosis and assessment of therapy.  Am J Med supplement 19(5B):54S-58S, 1991.

 

12.                 Ross PD, Genant HK, Davis JW, Miller P, Wasnich RD. Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporosis Int 3(3):120-127, 1993.

 

13.                 Ross PD, Davis JW, Wasnich RD. Bone mass and beyond: Risk factors for fractures. Calcif Tissue Inter 53(Suppl 1):S134-S138, 1993.

 

14.                 Wasnich RD, Davis JW, Ross PD. Spine fracture risk is predicted by non-spine fractures. Osteoporosis Int 4:1-5, 1994.

 

15.                 Wasnich RD. Bone mass measurement: Prediction of risk. Am J Med 95(Suppl 5A): S6-S10, 1993.

 

16.                 Ross PD, He Y-F, Davis JW, Epstein RS, Wasnich RD.  Normal ranges for bone loss rates. Bone Miner 26:169-180, 1994.

 

17.                 Wasnich RD.  Selection of Postmenopausal Women for Pharmacologic Osteoporosis Intervention.  Osteoporosis Int (1993) Suppl. 1:S70-71.

 

18.                 Wasnich RD.  The role of fracture risk assessment in osteoporosis prevention.  Osteoporosis Japan 3(3):82(521)-92(532), 1995.

 

19.                 Wasnich, RD, Davis J, Spencer K, Berger M, Gibb G, Ross PD. The results of standardized fracture risk reporting upon physician prescribing patterns. [abstract] J Bone Miner Res 11(Suppl 1):S462, 1996.

 

20.                 Wasnich, RD. A New Standardized Approach to Fracture Risk Interpretation.  Hawaii Medical Journal Vol 55, pp. 141-143, August 1996.

 

21.                 Miller PD, Bonnick SL, Rosen CJ, Altman RD, Avioli LV, Dequeker J, Felsenberg D, Genant HK, Gennari C, Harper KD, Hodsman AB, Kleerekoper M, Mautalen CA, McClung MR, Meunier PJ, Nelson DA, Peel NFA, Raisz LG, Recker RR, Utian WH, Wasnich RD, Watts NB.  Clinical Utility of Bone Mass Measurements in Adults:  Consensus of an International Panel. Seminars in Arthritis and Rheumatism. Soc for Clin Dens.  Vol 25, No. 6, pp. 361-372, 1996.

 

22.                 Wasnich RD. Consensus and the T-score Fallacy. Clin Rheumatol, 1997, 16:337-339.

 

23.                 Wasnich, RD.  Using the internet to report remaining lifetime fracture probability.  Drug Info Assoc 32(4):1005-1010

 

24.                 Wasnich RD.  A new, standardized approach to fracture risk interpretation.  Hawaii Med J 55(8):131-3, 1996.

 

25.                 Melton LJ III, Orwoll ES,  Wasnich RD.  Does Bone Density Predict Fractures Comparably in Men and Women?  Osteoporosis International, 2001, 12:707-709.

 

26.                 Ohtsuka M, Spencer B and Wasnich RD.  E-medicine: A new approach to osteoporosis management.  Journal of Musculoskeletal Medicine; 18(8):387-391, August 2001.

 

27.                 National Institutes of Health Consensus Development Panel, Dr. Richard Wasnich, Speaker.  Osteoporosis Prevention, Diagnosis, and Therapy.  NIH Consensus Statement 2000 March 27-29; 17(1):1-45.