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Rapid whole-genome sequencing decreases infant morbidity and cost of hospitalization
Open accessAbstract
Genetic disorders are a leading cause of morbidity and mortality in infants. Rapid whole-genome sequencing (rWGS) can diagnose genetic disorders in time to change acute medical or surgical management (clinical utility) and improve outcomes in acutely ill infants. We report a retrospective cohort study of acutely ill inpatient infants in a regional children’s hospital from July 2016–March 2017. Forty-two families received rWGS for etiologic diagnosis of genetic disorders. Probands also received standard genetic testing as clinically indicated. Primary end-points were rate of diagnosis, clinical utility, and healthcare utilization. The latter was modelled in six infants by comparing actual utilization with matched historical controls and/or counterfactual utilization had rWGS been performed at different time points. The diagnostic sensitivity of rWGS was 43% (eighteen of 42 infants) and 10% (four of 42 infants) for standard genetic tests ( P = .0005). The rate of clinical utility of rWGS (31%, thirteen of 42 infants) was significantly greater than for standard genetic tests (2%, one of 42; P = .0015). Eleven (26%) infants with diagnostic rWGS avoided morbidity, one had a 43% reduction in likelihood of mortality, and one started palliative care. In six of the eleven infants, the changes in management reduced inpatient cost by $800,000–$2,000,000. These findings replicate a prior study of the clinical utility of rWGS in acutely ill inpatient infants, and demonstrate improved outcomes and net healthcare savings. rWGS merits consideration as a first tier test in this setting.
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“reflecting the clinical utility of rapid WGS in decreasing infant morbidity.”
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Metadata
- Authors
- Farnaes, L., Hildreth, A., Sweeney, N. M., Clark, M. M., Chowdhury, S., Nahas, S., Cakici, J. A., Benson, W., Kaplan, R. H., Kronick, R., Bainbridge, M. N., Friedman, J., Gold, J. J., Ding, Y., Veeraraghavan, N., Dimmock, D., & Kingsmore, S. F.
- Affiliations
- University of California San Diego (US)
- Rady Children's Institute for Genomic Medicine (US)
- Corresponding author
- Kingsmore, Stephen F.
- ORCID
- Venue
- npj Genomic Medicine
- Published
- 2018-04-04
- Volume
- 3
- Issue
- 1
- Pages
- 10-10
- ISSN
- 2056-7944 (ISSN-L)
- PMC
- PMC5884823
- OpenAlex
- W2795749588
- Cited by
- 445
- References
- 34
- Citations by year
- 2026: 33 · 2025: 39 · 2024: 51 · 2023: 67 · 2022: 69 · 2021: 68 · 2020: 60 · 2019: 46 · 2018: 11
- FWCI
- 28.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Genomic Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Human Genome Research Institute
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U19HD077693, R01HD101540)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Keywords
- rapid whole genome sequencing, infants, genetic disorders, diagnostic yield, clinical utility, health care utilization, hospital costs, acute illness, diagnostic sensitivity, palliative care, mortality
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