4.5 Review

What Has the Undiagnosed Diseases Network Taught Us About the Clinical Applications of Genomic Testing?

Journal

ANNUAL REVIEW OF MEDICINE
Volume 73, Issue -, Pages 575-585

Publisher

ANNUAL REVIEWS
DOI: 10.1146/annurev-med-042120-014904

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Funding

  1. National Institutes of Health [U01 HG007709, U54 HD083092]

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This review discusses the current state of genomic testing performed within the Undiagnosed Diseases Network (UDN), focusing on the strengths and limitations of whole-exome and whole-genome sequencing in clinical diagnostics and the importance of ongoing data reanalysis. It also describes the role of emerging technologies in improving diagnostic rates within the UDN.
Genetic testing has undergone a revolution in the last decade, particularly with the advent of next-generation sequencing and its associated reductions in costs and increases in efficiencies. The Undiagnosed Diseases Network (UDN) has been a leader in the application of such genomic testing for rare disease diagnosis. This review discusses the current state of genomic testing performed within the UDN, with a focus on the strengths and limitations of whole-exome and whole-genome sequencing in clinical diagnostics and the importance of ongoing data reanalysis. The role of emerging technologies such as RNA and long-read sequencing to further improve diagnostic rates in the UDN is also described. This review concludes with a discussion of the challenges faced in insurance coverage of comprehensive genomic testing as well as the opportunities for a larger role of testing in clinical medicine.

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