title: Reassessment of Genomic Sequence Variation to Harmonize Interpretation for Personalized Medicine.
abstract: Accurate interpretation of DNA sequence variation is a prerequisite for implementing personalized medicine. Discrepancies in interpretation between testing laboratories impede the effective use of genetic test results in clinical medicine. To better understand the underpinnings of these discrepancies, we quantified differences in variant classification internally over time and those between our diagnostic laboratory and other laboratories and resources. We assessed the factors that contribute to these discrepancies and those that facilitate their resolution. Our process resolved 72% of nearly 300 discrepancies between pairs of laboratories to within a one-step classification difference and identified key sources of data that facilitate changes in variant interpretation. The identification and harmonization of variant discrepancies will maximize the clinical use of genetic information; these processes will be fostered by the accumulation of additional population data as well as the sharing of data between diagnostic laboratories.
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; Emory Genetics Laboratory, Decatur, GA 30033, USA.
authors.forename: Kathryn B
authors.initials: KB
authors.lastname: Garber
authors.affiliation: GeneDx, Gaithersburg, MD 20877, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vincent
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; Emory Genetics Laboratory, Decatur, GA 30033, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Alexander
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; Emory Genetics Laboratory, Decatur, GA 30033, USA.
authors.forename: Lora J H
authors.initials: LJH
authors.lastname: Bean
authors.affiliation: GeneDx, Gaithersburg, MD 20877, USA.
authors.forename: Sherri
authors.initials: S
authors.lastname: Bale
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; Emory Genetics Laboratory, Decatur, GA 30033, USA. Electronic address: mhegde@emory.edu.
authors.forename: Madhuri
authors.initials: M
authors.lastname: Hegde
mesh_terms: D030541:Databases, Genetic; D005820:Genetic Testing / Q000592:standards*; D014644:Genetic Variation; D023281:Genomics; D006801:Humans; D057285:Precision Medicine; D017422:Sequence Analysis, DNA