학술논문

Clinical Pertinence Metric Enables Hypothesis-Independent Genome-Phenome Analysis for Neurologic Diagnosis
Document Type
Journal Article
Source
Segal, Michael M., Mostafa Abdellateef, Ayman W. El-Hattab, Brian S. Hilbush, Francisco M. De La Vega, Gerard Tromp, Marc S. Williams, Rebecca A. Betensky, and Joseph Gleeson. 2014. “Clinical Pertinence Metric Enables Hypothesis-Independent Genome-Phenome Analysis for Neurologic Diagnosis.” Journal of Child Neurology 30 (7): 881-888. doi:10.1177/0883073814545884. http://dx.doi.org/10.1177/0883073814545884.
Subject
whole exome sequencing
diagnosis
diagnostic decision support
Language
English
ISSN
0883-0738
Abstract
We describe an “integrated genome-phenome analysis” that combines both genomic sequence data and clinical information for genomic diagnosis. It is novel in that it uses robust diagnostic decision support and combines the clinical differential diagnosis and the genomic variants using a “pertinence” metric. This allows the analysis to be hypothesis-independent, not requiring assumptions about mode of inheritance, number of genes involved, or which clinical findings are most relevant. Using 20 genomic trios with neurologic disease, we find that pertinence scores averaging 99.9% identify the causative variant under conditions in which a genomic trio is analyzed and family-aware variant calling is done. The analysis takes seconds, and pertinence scores can be improved by clinicians adding more findings. The core conclusion is that automated genome-phenome analysis can be accurate, rapid, and efficient. We also conclude that an automated process offers a methodology for quality improvement of many components of genomic analysis.