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Next-generation sequencing-based genome diagnostics across clinical genetics centers: implementation choices and
Terry Vrijenhoek1, Ken Kraaijeveld2, Martin Elferink1
1Department of Medical Genetics, Centre for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Implementing next-generation sequencing (NGS) in clinical genetics revealed variations in diagnostic practices and informed consent. Strategic choices impact variant interpretation and reporting, highlighting the need for improved procedures in diagnostic genome care.
Area of Science:
- Genetics
- Medical Diagnostics
- Bioinformatics
Background:
- Next-generation sequencing (NGS) implementation in routine genetic diagnostics necessitates careful strategic decisions.
- Variations in clinical genetic centers' practices can affect diagnostic outcomes.
Purpose of the Study:
- To compare NGS-based diagnostic practices across eight clinical genetic centers in the Netherlands.
- To identify critical implementation choices and their impact on variant interpretation and reporting.
- To analyze ethical and legal aspects of informed consent for diagnostic NGS.
Main Methods:
- Comparative analysis of NGS diagnostic practices in eight Dutch clinical genetic centers.
- Genetic testing of nine pre-selected cardiomyopathy patients.
- Ethical and legal review of informed consent procedures.
Main Results:
- Most centers consistently reported pathogenic mutations, but diagnostic discrepancies occurred.
- Inconsistent diagnoses included underdiagnosis and alternative variant identification.
- Informed consent procedures were adequate for targeted gene panels but not for exome/genome sequencing.
Conclusions:
- Strategic choices in NGS implementation significantly influence diagnostic genome care.
- Informed consent procedures require enhancement for broad NGS applications (exome/genome).
- Enhanced collaboration between clinic, diagnostics, and research is crucial for comprehensive diagnostic genome care.
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