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Benign | Pathogenic | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Strong | Supporting | Stand Alone | Supporting | Moderate | Strong | Very Strong | |||||
Population Data | MAF is too high for disorder. BS1 OR observation in controls inconsistent with disease penetrance BS2 | BS1-SupportingBS2-Supporting | MAF is too high for disorder BA1 | PM2-Supporting PS4-Supporting | Absent in population databases PM2 PS4-Moderate | Prevalence in affecteds statistically increased over controls PS4 PM2-Strong | PM2-Very Strong PS4-Very Strong | ||||
Computational And Predictive Data | BP4-StrongBP1-Strong BP7-StrongBP3-Strong | Multiple lines of computational evidence suggest no impact BP4 Missense when only truncating cause disease BP1Silent variant with non predicted splice impact BP7In-frame indels in repeat w/out known function BP3 | Multiple lines of computational evidence support a deleterious effect on the gene /gene product PP3 PM4-Supporting PM5-Supporting PS1-Supporting PVS1-Supporting | Novel missense change at an amino acid residue where a different pathogenic missense change has been seen before PM5. Protein length changing variant PM4 PP3-Moderate PS1-Moderate PVS1-Moderate | Same amino acid change as an established pathogenic variant PS1 PP3-Strong PM4-Strong PM5-Strong PVS1-Strong | Predicted null variant in a gene where LOF is a known mechanism of disease PVS1 PS1-Very Strong PM4-Very Strong PM5-Very Strong PP3-Very Strong | |||||
Functional Data | Well-established functional studies show no deleterious effect BS3 | BS3-Supporting | Missense in gene with low rate of benign missense variants and path. missenses common PP2 PM1-Supporting PS3-Supporting | Mutational hot spot or well-studied functional domain without benign variation PM1 PP2-Moderate PS3-Moderate | Well-established functional studies show a deleterious effect PS3 PM1-Strong PP2-Strong | PP2-Very Strong PM1-Very Strong PS3-Very Strong | |||||
Segregation Data | Non-segregation with disease BS4 | BS4-Supporting | Co-segregation with disease in multiple affected family members PP1 | PP1-Moderate | PP1-Strong | PP1-Very Strong | |||||
De novo Data | PM6-Supporting PS2-Supporting | De novo (without paternity & maternity confirmed) PM6 PS2-Moderate | De novo (paternity & maternity confirmed) PS2 PM6-Strong | PM6-Very Strong PS2-Very Strong | |||||||
Allelic Data | BP2-Strong | Observed in trans with a dominant variant BP2 Observed in cis with a pathogenic variant BP2 | PM3-Supporting | For recessive disorders, detected in trans with a pathogenic variant PM3 | PM3-Strong | PM3-Very Strong | |||||
Other Databases | BP6-Strong | Reputable source w/out shared data = benign BP6Controversial | Reputable source = pathogenic PP5 Controversial | PP5-Moderate | PP5-Strong | PP5-Very Strong | |||||
Other Data | BP5-Strong | Found in case with an alternate cause BP5 | Patient’s phenotype or FH highly specific for gene PP4 | PP4-Moderate | PP4-Strong | PP4-Very Strong | |||||