Biology subjects

Zeiberg, D.

Publications and source records attributed to Zeiberg, D..

4 recordsLinked to original sources

bioRxiv2026

Ancestry-specific performance of variant effect predictors in clinical variant classification

Predicting the effects of genetic variants and assessing prediction performance are key computational tasks in genomic medicine. It has been shown that well-calibrated variant effect predictors can be reliably used as evidence towards establishing pathogenicity (or benignity) of missense variants, thereby rendering these variants suitable for use in (or exclusion from) the genetic diagnosis of rare Mendelian conditions. However, most predictors have been trained or calibrated on data that may not be sufficiently representative to lead to similar performance across all genetic ancestries. This raises questions about the responsible deployment of these tools to improve human health. To better understand the utility of computational predictors, we set out to assess their ancestry-specific performance in terms of accuracy and evidence strength according to the ACMG/AMP guidelines. First, we determined that the expected count of rare variants in an individuals genome and the allele frequency distribution of these variants are the key confounders when evaluating a predictors performance across different genetic ancestries. Second, we found that a predictors accuracy itself inversely correlates with the allele frequency of the rare variant. After stratifying according to allele frequency, we show that established methods for predicting the pathogenicity of missense variants have comparable performance levels across major ancestry groups. Our results therefore support the wide deployment of such models in the context of genetic diagnosis and related applications.

bioinformatics↗

bioRxiv2026

A scalable approach to resolving variants of uncertain significance

Over 90% of missense variants across [~]4,000 disease-associated genes are variants of uncertain significance (VUS). Experimental variant effect measurements provide critical evidence about pathogenicity and inform disease biology, but most variants lack data and clinical translation has been limited. The Impact of Genomic Variation on Function Consortium generated experimental data for 62,215 variants across ten genes using multiplexed assays and 1,407 variants across 163 genes using arrayed assays, curated 193,139 additional community-generated variant effect measurements across 30 additional genes, and developed automated calibration methods for translating experimental data and variant effect predictions into clinical evidence. To reduce current VUS, we developed a scalable workflow using only experimental and predictive evidence, enabling reclassification of 75% of the 16,115 VUS in these genes as pathogenic or benign with <1% error. To minimize future VUS, we analyzed >90,000 unobserved variants; 62% had enough evidence to be "preclassified" as pathogenic or benign. We validated our data, evidence and classifications using All of Us and created interactive resources to enable clinical use of the calibrated data. Thus, for 40 genes, representing 1% of the clinical genome, we resolve most existing VUS and future variants, illustrating how systematic use of scalable evidence can empower genomic medicine.

genomics↗

bioRxiv2026

An integrated, scaled approach to resolve TSC2 variants of uncertain significance

Obtaining a precise genetic tuberous sclerosis diagnosis is a challenge as many missense TSC2 variants are variants of uncertain significance (VUS). VUS in TSC2 have been resolved by one-at-a-time functional assays, but these assays cannot scale to the 3,634 TSC2 missense VUS observed so far. To address this challenge, we used massively parallel sequencing to measure the steady-state abundance of almost 9,000 TSC2 missense variants and developed an mTOR pathway activity assay using genome editing and cell sorting to generate activity scores for 391 missense variants. 1,288 of 8,891 (14.49%) missense variants assayed had altered TSC2 abundance, and 69 of 391 (17.65%) missense variants assayed had altered mTOR pathway activity. Calibration and integration of these data into classification of variants identified in a clinical cohort putatively reclassified 212 of 276 (76.8%) TSC2 missense VUS. These datasets will lead to improved genetic diagnosis of tuberous sclerosis with potential positive impacts on the clinical management of patients and their families.

genetics↗

bioRxiv2025

Gene-based calibration of high-throughput functional assays for clinical variant classification

High-throughput assays measure a broad range of variant effects on gene function and hold promise for supporting genomic medicine. Current clinical guidelines for rare Mendelian diseases rely on establishing gene-specific score thresholds for each assay that separate pathogenic from benign variants. This introduces inconsistencies and subjectivity, ultimately lacking the rigor of calibration; i.e., mapping a variant score to a probability of pathogenicity. To address this problem, we introduce a semi-supervised framework for calibrating experimental assay data and propose Experimental score CALIBRator (ExCALIBR), a method that jointly models pathogenic, benign, synonymous, and population variants using skew normal mixtures to produce variant-specific probabilities of pathogenicity. Evaluated across 80 datasets from 39 genes, all meeting fit quality criteria, ExCALIBR substantially outperformed existing field standards and was further validated on the All of Us biobank data. Our results demonstrate that calibrated experimental assays generate indispensable evidence that will dramatically reduce variants of uncertain significance.

bioinformatics↗