Points to consider for sharing variant-level information from clinical genetic testing with ClinVar

Abstract

Data sharing between laboratories, clinicians, researchers, and patients is essential for improvements and standardization in genomic medicine; encouraging genomic data sharing (GDS) is a key activity of the National Institutes of Health (NIH)-funded Clinical Genome Resource (ClinGen). The ClinGen initiative is dedicated to evaluating the clinical relevance of genes and variants for use in precision medicine and research. Currently, data originating from each of the aforementioned stakeholder groups is represented in ClinVar, a publicly available repository of genomic variation, and its relationship to human health hosted by the National Center for Biotechnology Information at the NIH. Although policies such as the 2014 NIH GDS policy are clear regarding the mandate for informed consent for broad data sharing from research participants, no clear guidance exists on the level of consent appropriate for the sharing of information obtained through clinical testing to advance knowledge. ClinGen has collaborated with ClinVar and the National Human Genome Research Institute to develop points to consider for clinical laboratories on sharing de-identified variant-level data in light of both the NIH GDS policy and the recent updates to the Common Rule. We propose specific data elements from interpreted genomic variants that are appropriate for submission to ClinVar when direct patient consent was not sought and describe situations in which obtaining informed consent is recommended.

Figure 1.

ClinVar display of data elements appropriate for public data sharing without explicit consent. (A) Standardized description of variant; (B) submitter's clinical significance assertion; (C) condition and inheritance pattern on which the submitter based the pathogenicity assertion; (D) name of submitter; (E) evidence on which the submitter based the clinical significance assertion. Selected views from ClinVar variation display for variation ID 43565 (https://www.ncbi.nlm.nih.gov/clinvar/variation/43565/ Accessed September 2017).