Division of Cardiovascular Medicine.
Cardiovascular Institute.
Curr Opin Lipidol. 2021 Apr 1;32(2):89-95. doi: 10.1097/MOL.0000000000000733.
Polygenic scores (PGS) are used to quantify the genetic predisposition for heritable traits, with hypothesized utility for personalized risk assessments. Lipid PGS are primed for clinical translation, but evidence-based practice changes will require rigorous PGS standards to ensure reproducibility and generalizability. Here we review applicable reporting and technical standards for dyslipidemia PGS translation along phases of the ACCE (Analytical validity, Clinical validity, Clinical utility, Ethical considerations) framework for evaluating genetic tests.
New guidance suggests existing standards for study designs incorporating the ACCE framework are applicable to PGS and should be adopted. One recent example is the Clinical Genomics Resource (ClinGen) and Polygenic Score Catalog's PRS reporting standards, which define minimal requirements for describing rationale for score development, study population definitions and data parameters, risk model development and application, risk model evaluation, and translational considerations, such as generalizability beyond the target population studied.
Lipid PGS are likely to be integrated into clinical practice in the future. Clinicians will need to be prepared to determine if and when lipid PGS is useful and valid. This decision-making will depend on the quality of evidence for the clinical use of PGS. Establishing reporting standards for PGS will help facilitate data sharing and transparency for critical evaluation, ultimately benefiting the efficiency of evidence-based practice.
多基因评分(PGS)用于量化遗传性状的遗传易感性,假设其在个性化风险评估中有应用价值。脂质 PGS 已准备好进行临床转化,但基于证据的实践改变将需要严格的 PGS 标准,以确保可重复性和通用性。在这里,我们回顾了适用的血脂异常 PGS 翻译报告和技术标准,这些标准沿着评估遗传检测的 ACCE(分析有效性、临床有效性、临床实用性、伦理考虑)框架的各个阶段进行。
新的指南表明,纳入 ACCE 框架的研究设计的现有标准适用于 PGS,应予以采用。最近的一个例子是临床基因组资源(ClinGen)和多基因评分目录的 PRS 报告标准,该标准定义了描述评分开发、研究人群定义和数据参数、风险模型开发和应用、风险模型评估以及转化考虑因素(例如目标人群之外的通用性)的基本要求。
未来,脂质 PGS 可能会整合到临床实践中。临床医生需要准备好确定是否以及何时使用脂质 PGS 是有用和有效的。这一决策将取决于 PGS 临床应用的证据质量。建立 PGS 的报告标准将有助于促进数据共享和透明度,以便进行关键评估,最终有利于基于证据的实践效率。