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Evidence from 2100 index cases supports genome sequencing as a first-tier genetic test. | LitMetric

AI Article Synopsis

  • Genome sequencing (GS) is a powerful method for identifying various genetic variants, but its full clinical effectiveness is still being assessed.
  • An evaluation of 2100 clinical GS cases showed an overall diagnostic yield of 28%, with a yield of 26% when GS was used as the first test.
  • GS was particularly beneficial for patients who had previously received non-diagnostic tests, leading to diagnoses in 27% of those cases, suggesting that GS could be the preferred first-tier genetic test to expedite diagnosis.

Article Abstract

Purpose: Genome sequencing (GS) is one of the most comprehensive assays that interrogate single-nucleotide variants, copy number variants, mitochondrial variants, repeat expansions, and structural variants in a single assay. Despite the clear technical superiority, the full clinical utility of GS has yet to be determined.

Methods: We systematically evaluated 2100 clinical GS index cases performed in our laboratory to explore the diagnostic yield of GS as first-tier and as follow-up testing.

Results: The overall diagnostic yield was 28% (585/2100). The diagnostic yield for GS as the first-tier test was 26% (294/1146). Among cases with prior non-diagnostic genetic tests, GS provided a diagnosis for 27% (247/910) of cases, including 56 cases with prior exome sequencing (ES). Although re-analysis of previous ES might have resolved the diagnosis in 29 cases, diagnoses for 27 cases would have been missed because of the technical inferiority of ES. Moreover, GS further disclosed additional genetic etiology in 3 out of 44 cases with existing partial diagnosis.

Conclusion: We present the largest-to-date GS data set of a clinically heterogeneous cohort from a single clinical laboratory. Our data demonstrate that GS should be considered as the first-tier genetic test that has the potential to shorten the diagnostic odyssey.

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Source
http://dx.doi.org/10.1016/j.gim.2023.100995DOI Listing

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