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Finding disease variants in Mendelian disorders by using sequence data: methods and applications.
[kabuki syndrome]
Many
sequencing
studies
are
now
underway
to
identify
the
genetic
causes
for
both
Mendelian
and
complex
traits
.
Via
exome-sequencing
,
genes
harboring
variants
implicated
in
several
Mendelian
traits
have
already
been
identified
.
The
underlying
methodology
in
these
studies
is
a
multistep
algorithm
based
on
filtering
variants
identified
in
a
small
number
of
affected
individuals
and
depends
on
Â
whether
they
are
novel
(
not
yet
seen
in
public
resources
such
as
dbSNP
)
,
shared
among
affected
individuals
,
and
other
external
functional
information
on
the
variants
.
Although
intuitive
,
these
filter-based
methods
are
nonoptimal
and
do
not
provide
any
measure
of
statistical
uncertainty
.
We
describe
here
a
formal
statistical
approach
that
has
several
distinct
advantages
:
(
1
)
it
provides
fast
computation
of
approximate
p
values
for
individual
genes
,
(
2
)
it
adjusts
for
the
background
variation
in
each
gene
,
(
3
)
it
allows
for
incorporation
of
functional
or
linkage-based
information
,
and
(
4
)
it
accommodates
designs
based
on
both
affected
relative
pairs
and
unrelated
affected
individuals
.
We
show
via
simulations
that
the
proposed
approach
can
be
used
in
conjunction
with
the
existing
filter-based
methods
to
achieve
a
substantially
better
ranking
of
a
gene
relevant
for
disease
when
compared
to
currently
used
filter-based
approaches
,
this
is
especially
so
in
the
presence
of
disease
locus
heterogeneity
.
We
revisit
recent
studies
on
three
Mendelian
Â
diseases
and
show
that
the
proposed
approach
results
in
the
implicated
gene
being
ranked
first
in
all
studies
,
and
approximate
p
values
of
10
(
-
6
)
for
the
Miller
Syndrome
gene
,
1
.
0
Â
×
10
(
-
4
)
for
the
Freeman-
Sheldon
Syndrome
gene
,
and
3
.
5
Â
×
10
(
-
5
)
for
the
Kabuki
Syndrome
gene
.
Diseases
Validation
Diseases presenting
"several distinct advantages"
symptom
kabuki syndrome
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