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. Author manuscript; available in PMC: 2015 Jul 1.
Published in final edited form as: Health Aff (Millwood). 2014 Jul 1;33(7):1246–1253. doi: 10.1377/hlthaff.2014.0020

Exhibit 1. A Classification Of Sequencing Characteristics.

Sequencing Input

Which patients are sequenced
 People with risk factors or symptoms (disease-specific genomic medicine)
 People in the general population with no known risk factors (general genomic medicine)
Why patients are sequenced
 Diagnosis
 Treatment decisions and monitoring
 Detection of future risk
 Reproductive planning (preconception and prenatal screening)
 Newborn screening
What is sequenced
 Genetic information of a person present at birth (inherited or germline)
 Genetic information of a disease-state material in a person (for example, tumor or infection) that emerges during the person's life (somatic or acquired)

Sequencing Methods

Technology used
 Platform used (machine, chemistry, and software), interpretation, and reporting standards
 Accuracy and reproducibility of results
Extent of sequencing
 Single mutation testing
 Testing of panels of multiple genes or regions
 Whole exome sequencing
 Whole genome sequencing

Sequencing Output

Findings examined and reported
 Disease specific
 Incidental or secondary
 Of unknown significance
Clinical relevance of findings
 Variants with known clinical validity and utility (where an intervention exists that is associated with improved patient outcomes)
 Variants that may not currently be directly actionable
 Variants with unknown or no clinical significance
 Findings used for research purposes only