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A protocol for whole-exome sequencing in newborns with congenital deafness: a prospective population-based cohort
Lilian Downie1,2,3,4, Jane L Halliday2,4, Rachel A Burt2,4
1Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.
Insights
This study uses whole-exome sequencing (WES) to identify genetic causes of congenital hearing loss in infants. It also explores parental preferences for receiving additional genetic findings from the WES test.
Area of Science:
- Genetics
- Paediatrics
- Genomic Medicine
Background:
- Congenital hearing loss has a heterogeneous aetiology, with genetic factors frequently suspected.
- Parents often experience a prolonged diagnostic journey to determine the cause of their infant's hearing loss.
Purpose of the Study:
- To determine the genetic causes of congenital hearing loss in infants using whole-exome sequencing (WES) and chromosome microarray.
- To evaluate parental choices regarding receiving additional findings from infant WES.
- To assess parental experiences with WES for diagnosing congenital hearing loss.
Main Methods:
- Prospective cohort study identifying infants through the Victorian Infant Hearing Screening Program.
- Infants offered paediatrician and genetics assessment, with consent for WES and chromosome microarray.
- Surveys used to evaluate parents' experience and preferences for counselling and information provision.
Main Results:
- The project will provide a descriptive analysis of the genetic aetiology of congenital hearing loss.
- Potential data on genotype-phenotype correlations will be generated.
- Parental choices regarding additional genetic findings will be analyzed.
Conclusions:
- This research will enhance understanding of the genetic basis of congenital hearing loss.
- It will inform genetic testing strategies and parental support in diagnosing hearing impairment.
- The study aims to generalize findings across a diverse population, improving diagnostic yield and patient care.
Introduction:
The aetiology of congenital hearing loss is heterogeneous, and in many infants a genetic cause is suspected. Parents face a diagnostic odyssey when searching for a cause of their infant's hearing loss. Through the Melbourne Genomics Health Alliance, a prospective cohort of infants will be offered whole-exome sequencing (WES) with targeted analysis in conjunction with chromosome microarray to determine the genetic causes of congenital hearing loss. Parents will also be offered the opportunity to receive additional results from their infant's WES.
Methods:
Eligible infants will be identified through the Victorian Infant Hearing Screening Program and offered an appointment in a paediatrician-run clinic, a genetics assessment and enrolment in the Victorian Childhood Hearing Impairment Longitudinal Databank. If parents consent to WES, genes causing deafness will be analysed and they can choose to obtain additional findings. For the additional results component, a modified laboratory protocol has been designed for reporting of results in the absence of a relevant phenotype. Parents' experience of being offered WES will be evaluated using surveys.
Discussion:
This project will provide descriptive analysis of the genetic aetiology of congenital hearing loss in this cohort and may provide data on genotype-phenotype correlations. Additionally, choices regarding additional findings will be analysed. Participants will represent a diverse cross section of the population, increasing the ability to generalise results beyond the study group. Evaluation surveys will allow analysis of preferences around counselling, usefulness of a decision aid and adequacy of information provision.
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