Description and pilot results from a novel method for evaluating return of incidental findings from next-generation sequencing technologies Journal Article


Authors: Goddard, K. A. B.; Whitlock, E. P.; Berg, J. S.; Williams, M. S.; Webber, E. M.; Webster, J. A.; Lin, J. S.; Schrader, K. A.; Campos-Outcalt, D.; Offit, K.; Feigelson, H. S.; Hollombe, C.
Article Title: Description and pilot results from a novel method for evaluating return of incidental findings from next-generation sequencing technologies
Abstract: Purpose: The aim of this study was to develop, operationalize, and pilot test a transparent, reproducible, and evidence-informed method to determine when to report incidental findings from next-generation sequencing technologies. Methods: Using evidence-based principles, we proposed a three-stage process. Stage I "rules out" incidental findings below a minimal threshold of evidence and is evaluated using inter-rater agreement and comparison with an expert-based approach. Stage II documents criteria for clinical actionability using a standardized approach to allow experts to consistently consider and recommend whether results should be routinely reported (stage III). We used expert opinion to determine the face validity of stages II and III using three case studies. We evaluated the time and effort for stages I and II. Results: For stage I, we assessed 99 conditions and found high inter-rater agreement (89%), and strong agreement with a separate expert-based method. Case studies for familial adenomatous polyposis, hereditary hemochromatosis, and α1-antitrypsin deficiency were all recommended for routine reporting as incidental findings. The method requires <3 days per topic. Conclusion: We establish an operational definition of clinically actionable incidental findings and provide documentation and pilot testing of a feasible method that is scalable to the whole genome. © American College of Medical Genetics and Genomics.
Keywords: gene mutation; gene sequence; evidence based practice; mass screening; homozygosity; pilot study; hemochromatosis; incidental finding; genetic screening; newborn screening; external validity; face validity; familial colon polyposis; next generation sequencing; whole-exome sequencing; clinical actionability; population screening; secondary findings; whole-genome sequencing; alpha 1 antitrypsin deficiency
Journal Title: Genetics in Medicine
Volume: 15
Issue: 9
ISSN: 1098-3600
Publisher: Nature Publishing Group  
Date Published: 2013-09-01
Start Page: 721
End Page: 728
Language: English
DOI: 10.1038/gim.2013.37
PROVIDER: scopus
PUBMED: 23558254
PMCID: PMC3927794
DOI/URL:
Notes: --- - "Export Date: 1 October 2013" - "CODEN: GEMEF" - "Source: Scopus"
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  1. Kenneth Offit
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