Murray Michael F
Yale Center for Genomic Health, Yale School of Medicine, New Haven, CT 06510, USA.
J Pers Med. 2022 Jan 26;12(2):158. doi: 10.3390/jpm12020158.
Over the past decade, the secondary analysis of existing DNA datasets for clinical resulting has become an established practice. However, this established practice is typically limited to only one category of secondary genomic findings, the identification of "disease risk". Diagnostic resulting has been left out of secondary genomic findings. In medical practice, diagnostic resulting is triggered when a test is ordered for a patient based on a recognizable clinical indication for evaluation; most genetic and genomic testing is carried out in support of diagnostic evaluations. The secondary analysis of existing DNA data has the potential to cost less and have more rapid turnaround times for compared to current DNA diagnostic approaches that typically generate a new dataset with every test ordered. Worldwide, innovative health systems could position themselves to deliver valid secondary genomic finding results in both the established category of , as well as a new category of . To support the ongoing delivery of both categories of secondary findings, health systems will need comprehensive genomic datasets for patients and secure workflows that allow for repeated access to that data for on-demand secondary analysis.
在过去十年中,对现有DNA数据集进行临床结果的二次分析已成为一种既定做法。然而,这种既定做法通常仅限于一类二次基因组发现,即“疾病风险”的识别。诊断结果被排除在二次基因组发现之外。在医疗实践中,当根据可识别的临床评估指征为患者安排检测时,就会触发诊断结果;大多数基因和基因组检测都是为了支持诊断评估而进行的。与当前通常每次安排检测都会生成一个新数据集的DNA诊断方法相比,对现有DNA数据进行二次分析可能成本更低,周转时间更快。在全球范围内,创新的卫生系统可以使自己在既定的类别以及新的类别中提供有效的二次基因组发现结果。为了支持持续提供这两类二次发现,卫生系统将需要患者的全面基因组数据集以及安全的工作流程,以便能够重复访问该数据以进行按需二次分析。