Title |
Whole-exome sequencing reanalysis at 12 months boosts diagnosis and is cost-effective when applied early in Mendelian disorders
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Published in |
Genetics in Medicine, March 2018
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DOI | 10.1038/gim.2018.39 |
Pubmed ID | |
Authors |
Lisa J Ewans, Deborah Schofield, Rupendra Shrestha, Ying Zhu, Velimir Gayevskiy, Kevin Ying, Corrina Walsh, Eric Lee, Edwin P Kirk, Alison Colley, Carolyn Ellaway, Anne Turner, David Mowat, Lisa Worgan, Mary-Louise Freckmann, Michelle Lipke, Rani Sachdev, David Miller, Michael Field, Marcel E Dinger, Michael F Buckley, Mark J Cowley, Tony Roscioli |
Abstract |
PurposeWhole-exome sequencing (WES) has revolutionized Mendelian diagnostics, however, there is no consensus on the timing of data review in undiagnosed individuals and only preliminary data on the cost-effectiveness of this technology. We aimed to assess the utility of WES data reanalysis for diagnosis in Mendelian disorders and to analyze the cost-effectiveness of this technology compared with a traditional diagnostic pathway.MethodsWES was applied to a cohort of 54 patients from 37 families with a variety of Mendelian disorders to identify the genetic etiology. Reanalysis was performed after 12 months with an improved WES diagnostic pipeline. A comparison was made between costs of a modeled WES pathway and a traditional diagnostic pathway in a cohort with intellectual disability (ID).ResultsReanalysis of WES data at 12 months improved diagnostic success from 30 to 41% due to interim publication of disease genes, expanded phenotype data from referrer, and an improved bioinformatics pipeline. Cost analysis on the ID cohort showed average cost savings of US$586 (AU$782) for each additional diagnosis.ConclusionEarly application of WES in Mendelian disorders is cost-effective and reanalysis of an undiagnosed individual at a 12-month time point increases total diagnoses by 11%.GENETICS in MEDICINE advance online publication, 29 March 2018; doi:10.1038/gim.2018.39. |
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Country | Count | As % |
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Netherlands | 5 | 23% |
United Kingdom | 4 | 18% |
United States | 3 | 14% |
France | 1 | 5% |
New Zealand | 1 | 5% |
Greece | 1 | 5% |
Saudi Arabia | 1 | 5% |
Unknown | 6 | 27% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 14 | 64% |
Scientists | 5 | 23% |
Science communicators (journalists, bloggers, editors) | 2 | 9% |
Practitioners (doctors, other healthcare professionals) | 1 | 5% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 177 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 30 | 17% |
Student > Ph. D. Student | 17 | 10% |
Other | 15 | 8% |
Student > Master | 15 | 8% |
Student > Bachelor | 12 | 7% |
Other | 34 | 19% |
Unknown | 54 | 31% |
Readers by discipline | Count | As % |
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Biochemistry, Genetics and Molecular Biology | 54 | 31% |
Medicine and Dentistry | 25 | 14% |
Agricultural and Biological Sciences | 9 | 5% |
Economics, Econometrics and Finance | 5 | 3% |
Unspecified | 4 | 2% |
Other | 18 | 10% |
Unknown | 62 | 35% |