A Pilot Meta-research on Evolving Evidence Behind Genetic Variant (Re)Classification

Variant classification and reclassification are fundamental to advancing precision medicine. This study focuses on the reclassifications of variants of uncertain significance (VUS) in BRCA1 and BRCA2 genes. By analyzing 162 unique cited publications supporting VUS reclassifications, we examined the accuracy, completeness, and currency of citations to these publications. Our findings reveal missing or inadequate evidence for reclassifications, as well as temporally misaligned citations and ClinVar submissions. Furthermore, we observed patterns in the cited studies, including the use of classification recommendations, genetic mechanisms, computational tools, and diverse population studies. This study underscores the need for stronger evidence supporting reclassifications and greater inclusion of diverse populations to optimize genomic variant reclassification and clinical decision-making.