Bioinformatics
The analysis is designed to target the specific genomic region harboring the targeted variant of interest. This includes the variant locus and, where applicable, adjacent bases required to ensure accurate detection.
Sequencing data is processed through a proprietary analysis and annotation pipeline that integrates state-of-the-art algorithms and industry-standard software solutions. Multiple quality control steps are embedded throughout the workflow to ensure the accuracy, validity, and consistency of the results. The pipeline is optimized to maximize sensitivity without compromising specificity.
All findings are summarized in a clear and detailed clinical report. This report includes sequencing quality metrics and coverage of the targeted region and the variant locus, and highlights any regions where coverage is limited (<20x for nuclear DNA and <1000x for mtDNA, when applicable). This ensures transparency and supports accurate clinical interpretation.
When the targeted variant is located in the mitochondrial genome, the analysis includes the relevant mitochondrial region.
Test Performance
This assay is designed to detect a predefined targeted variant based on prior clinical or molecular findings. The test is optimized for the accurate identification of the specified variant and is not intended for comprehensive analysis of the entire gene or genomic region unless otherwise stated.
The assay is based on a high-quality, clinical-grade next-generation sequencing (NGS) methodology. Depending on the nature of the targeted variant, the analysis may include detection of single nucleotide variants (SNVs), small insertions and deletions (indels), and, when applicable, copy number variants (CNVs). Details regarding the detection of different types of genetic alterations are provided in the sequencing and detection performance table (see Table).
The assay has been validated for several sample types, including EDTA blood, isolated DNA (excluding DNA from formalin-fixed paraffin-embedded tissue), saliva, and dried blood spots (filter cards). These sample types were selected to ensure reliable DNA quality and performance.
The performance metrics shown below are based on initial validation studies at an accredited clinical laboratory, with equivalent results confirmed across additional laboratory sites.
Performance of a high-quality, clinical-grade NGS sequencing assay
| Variant type |
Sensitivity % (TP/(TP+FN)) |
Specificity % |
| Single-nucleotide variants (SNVs) |
99.89% (99,153/99,266) |
>99.9999% |
| Insertions, deletions, and indels by sequence analysis |
| 1-10 bps |
99.2% (7,745/7,806) |
>99.9999% |
| 11-50 bps |
99.13% (2,524/2,546) |
>99.9999% |
| Copy number variants (exon level dels/dups) |
| 1 exon deletion (het) |
100% (20/20) |
NA |
| 1 exon deletion (homo) |
100% (5/5) |
NA |
| 1 exon deletion (het or homo) |
100% (25/25) |
NA |
| 2-7 exon deletion (het or homo) |
100% (44/44) |
NA |
| 1-9 exon duplication (het or homo) |
75% (6/8) |
NA |
| Simulated CNV detection |
| 5 exons del/dup |
98.7% |
100.00% |
| Microdeletions/-duplications (n=37) |
| Size range (0.1–47 Mb) |
100% (25/25) |
|
Coverage metrics
| Mean sequencing depth |
143X |
| Nucleotides with >20x coverage (%) |
99.86% |
Performance of Mitochondrial Sequencing Assay
| Variant type/condition |
Sensitivity % |
Specificity % |
| Analytic validation (n=4 samples) |
| SNVs Heteroplasmic (45-100%) |
100% (50/50) |
100% |
| SNVs Heteroplasmic (35-45%) |
100% (87/87) |
100% |
| SNVs Heteroplasmic (25-35%) |
100% (73/73) |
100% |
| SNVs Heteroplasmic (15-25%) |
100% (77/77) |
100% |
| SNVs Heteroplasmic (10-15%) |
100% (74/74) |
100% |
| SNVs Heteroplasmic (5-10%) |
100% (3/3) |
100% |
| SNVs Heteroplasmic (<5%) |
50% (2/4) |
100% |
| Clinical validation (n=76 samples) |
| SNVs Heteroplasmic (45-100%) |
100% (1940/1940) |
100% |
| SNVs Heteroplasmic (35-45%) |
100% (4/4) |
100% |
| SNVs Heteroplasmic (25-35%) |
100% (3/3) |
100% |
| SNVs Heteroplasmic (15-25%) |
100% (3/3) |
100% |
| SNVs Heteroplasmic (10-15%) |
100% (9/9) |
100% |
| SNVs Heteroplasmic (5-10%) |
92.3% (12/13) |
99.98% |
| SNVs Heteroplasmic (<5%) |
88.9% (48/54) |
99.93% |
| Indels 1-10bp (het 45-100%) |
100% (32/32) |
100% |
| Indels 1-10bp (het 5-45%) |
100% (3/3) |
100% |
| Indels 1-10bp (het <5%) |
100% (5/5) |
99.997% |
| Simulation data |
| Indels 1-24bp Homoplasmic (100%) |
100% (17/17) |
99.98% |
| Indels 1-24bp Heteroplasmic (50%) |
100% (17/17) |
99.99% |
| Indels 1-24bp Heteroplasmic (25%) |
100% (17/17) |
100% |
| Indels 1-24bp Heteroplasmic (20%) |
100% (17/17) |
100% |
| Indels 1-24bp Heteroplasmic (15%) |
100% (17/17) |
100% |
| Indels 1-24bp Heteroplasmic (10%) |
94.1% (16/17) |
100% |
| Indels 1-24bp Heteroplasmic (5%) |
94.1% (16/17) |
100% |
| CNVs (artificial mutations; n=1500) |
| Homoplasmic (100%) 500bp–5kb |
100% |
100% |
| Heteroplasmic (50%) 500bp–5kb |
100% |
100% |
| Heteroplasmic (30%) 500bp–5kb |
100% |
100% |
| Heteroplasmic (20%) 500bp–5kb |
99.7% |
100% |
| Heteroplasmic (10%) 500bp–5kb |
99.0% |
100% |
Mitochondrial assay coverage metrics
| Metric |
Mean of medians |
Median of medians |
| Mean sequencing depth MQ0 (clinical) |
18224X |
17366X |
| Nucleotides with >1000x MQ0 coverage (%) |
100% |
|
| ρ0 cell line (=no mtDNA), mean sequencing depth |
12X |
|