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Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

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Page 1: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

Yvonne Wallis

UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants

MeetingEdinburgh 01.03.13

Page 2: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

UV Best Practice Meeting

April 2007 NOWGENCMGS/Dutch labs/Special

guests Jennie Bell/Simon Ramsden

1st Best Practice GuidelinesJanuary 2008

Interpretation & Reporting of UVs

Follow up Best Practice Meeting

March 2011 BirminghamCMGS labs

Draft Updated Guidelines

February 2013Interpretation & Reporting of Rare & Novel Variants

UKNEQAS UV Participants WorkshopMarch 2013

Pathogenicity of sequence variants

interpretation Pilot EQA scheme

2012

Final Updated GuidelinesMarch 2013

Interpretation & Reporting of Rare & Novel Variants

Page 3: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

Follow up best practise meeting March 20112008 guidelines in place for 3 years

Very good base-useful and were used/referenced Embedded within our discipline Facilitated a more standardised approach within labs to

variant assessment

Time to review them Still accurate? New information? Reflect actual practice? Was there consistency across labs?

Do labs apply/use common strategies/rules?

Uncertainty about the use of in silico tools How to use them Trust them/apply them

Meeting aim-review each section in turn to expand and consolidate where necessary

Page 4: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

Revision process: to produce 2013 DRAFT versionMEETING-2011

Each section reviewed/discussedChanges agreed Individuals nominated to make changes as appropriateKathryn Robertson coordinated revision process

POST MEETINGDutch lab members reviewedFurther reiterationsLots of changes Final draft Feb 2013 (YW-used judgement and common

sense!)

Please flag errorsToday or [email protected]

Page 5: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

Number of outstanding issuesOverlap with outcomes from UKNEQAS UV pilot scheme

2012

TODAYComing togetherReach consensusRecommendations incorporated in to the final version

OVER LUNCH:New Title:

Reporting and Interpretation of Rare or Novel Sequence Variants

Terminology: Use of “Variant of uncertain significance” Use of VUS (VOUS suggested by Dutch reviewers)

2013 DRAFT guidelines-what next?

Page 6: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

4.2 Presence or absence on SNP DatabasesSection promoted and extendedAdditional informationUseful/accurate/problems?What rules do labs use to assign benign

polymorphism?

4.5 Co-segregation with the disease in the familyInclusion of SISA

Simplified method for segregation analysis Background information or potentially useful? Criteria for it’s implementation?

What’s new and requires further discussion in v2?

Page 7: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

4.7 Species conservationSignificantly expanded

Lots of new referencesDoes it need more?

Nucleotide conservation? Use of PhyloP and PhastCons tools?

How much weight do labs put on this?Do labs create gene specific MSAs?

4.8 In silico prediction of pathogenic effectSignificant modification

New references Is this sufficient to support labs?

How much weight do labs put on this?Do labs validate tools using variants with known

effect?

What’s new and requires further discussion in v2?

Page 8: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

4.9 In silico splice site predictionSignificantly expandedAdditional references includedAlamut mentioned within this section

Note of caution Is this enough? Should instructions be included on how to use the

software?

Is information on scores of the prediction tools needed? Should there be suggested criteria for changes in scores

supporting consistent follow up studies? E.g., 10% deviation from the wild-type score

What’s new and requires further discussion in v2?

Page 9: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

5.4 Classification of variantsNumber of outstanding issues related4 vs 5 class system

Dutch reviewers recommend 4 categories UK team prefer 5 categories Overlap with NEQAS scheme outcomes

Should/could a common preferred system be implemented Common definitions Common wording Common recommendations for follow up studies

What’s new and requires further discussion in v2?

Page 10: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

Final ThoughtsLots of amendments

Lots of helpful information

IMPORTANT to close off outstanding issues

Never going to be perfect-evolving

TODAY-NOT a full BP meeting

Consensus from guidelines and NEQAS outcomes

1st BPs to be ratified by ACGS

Page 11: Yvonne Wallis UKNEQAS for Molecular Genetics Unclassified Sequence Variants Participants Meeting Edinburgh 01.03.13

AcknowledgementsParticipants attended the follow up BP

meeting 2011Kathryn RobertsonAndrew DevereauStewart PayneCiaron McAnultyDutch lab colleagues