Moyer Ann, Loo Eric, Cadoff Evan, Konnick Eric, Duncan Helena, Halley Jaimie, Hermina Katherine, Vasalos Patricia, Moncur Joel T, Yohe Sophia
From the Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, Minnesota (Moyer).
Department of Pathology and Medicine, Dartmouth Health, Lebanon, New Hampshire (Loo).
Arch Pathol Lab Med. 2025 Feb 1;149(2):152-158. doi: 10.5858/arpa.2023-0419-CP.
CONTEXT.—: Title 45, section 164.524 of the Code of Federal Regulations states that health care systems must provide patient health records upon that patient's request. For complex testing, such as next-generation sequencing (NGS), this raises questions related to what data should be released and the laboratory considerations regarding the release of this data.
OBJECTIVE.—: To describe the laboratory implications of releasing different NGS data files and the limitations for the clinical use of different NGS data files.
DESIGN.—: The College of American Pathologists workgroup, composed of laboratorians with expertise regarding NGS testing, reviewed pertinent literature, including title 45, section 164.524, and the Health and Human Services "Guidance on Individuals' Right to Access Health Information."
RESULTS.—: From an accreditation standpoint, validation of NGS includes both the wet bench and data processing (bioinformatics) portions, and appropriately validated laboratory testing is required to ensure quality patient results. NGS testing generates intermediate data files that have not completed the fully validated process but are often kept by the laboratory. These files may be requested by patients, but most patients will not be aware of the test validation process and the limitations of data that have not gone through a fully validated process.
CONCLUSIONS.—: Laboratories should encourage patients to receive their health data and to help individuals understand the content, uses, and limitations of laboratory data they have requested or received. NGS data used in a nonvalidated manner should not be used for clinical purposes without confirmation by a clinically validated method.
美国联邦法规法典第45编第164.524节规定,医疗保健系统必须应患者要求提供患者健康记录。对于诸如新一代测序(NGS)等复杂检测,这引发了有关应发布哪些数据以及发布这些数据的实验室考量等问题。
描述发布不同NGS数据文件的实验室影响以及不同NGS数据文件临床应用的局限性。
美国病理学家学会工作组由具有NGS检测专业知识的检验师组成,对相关文献进行了审查,包括第45编第164.524节以及卫生与公众服务部的《个人获取健康信息权利指南》。
从认证角度来看,NGS的验证包括湿实验台和数据处理(生物信息学)部分,需要进行适当验证的实验室检测以确保为患者提供高质量结果。NGS检测会生成尚未完成完全验证过程的中间数据文件,但实验室通常会保留这些文件。患者可能会要求获取这些文件,但大多数患者并不了解检测验证过程以及未经过完全验证过程的数据的局限性。
实验室应鼓励患者获取其健康数据,并帮助个人理解他们所要求或已获取的实验室数据的内容、用途和局限性。未经验证使用的NGS数据在未通过临床验证方法确认之前,不应将其用于临床目的。