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Systematic Evaluation of Sanger Validation of NextGen Sequencing Variants #MMPMID26847218
Beck TF; Mullikin JC; Biesecker LG
Clin Chem 2016[Apr]; 62 (4): 647-54 PMID26847218show ga
BACKGROUND: Next-generation sequencing (NGS) data are used for both clinical care and clinical research. DNA sequence variants identified using NGS are often returned to patients/participants as part of clinical or research protocols. The current standard of care is to validate NGS variants using Sanger sequencing, which is costly and time-consuming. METHODS: We performed a large-scale, systematic evaluation of Sanger-based validation of NGS variants using data from the ClinSeq® project. We first used NGS data from 19 genes in five participants, comparing them to high-throughput Sanger sequencing results on the same samples, and found no discrepancies among 234 NGS variants. We then compared NGS variants in five genes from 684 participants against data from Sanger sequencing. RESULTS: Of over 5,800 NGS-derived variants, 19 were not validated by Sanger data. Using newly-designed sequencing primers, Sanger sequencing confirmed 17 of the NGS variants, and the remaining two variants had low quality scores from exome sequencing. Overall, we measured a validation rate of 99.965% for NGS variants using Sanger sequencing, which was higher than many existing medical tests that do not necessitate orthogonal validation. CONCLUSIONS: A single round of Sanger sequencing is more likely to incorrectly refute a true positive variant from NGS than to correctly identify a false positive variant from NGS. Validation of NGS-derived variants using Sanger sequencing has limited utility, and best practice standards should not include routine orthogonal Sanger validation of NGS variants.