Much has been written about the promise of genome-scale sequencing in medicine, both for diagnosis of rare monogenic disorders and also perhaps as part of routine patient care.1 Yet no matter the indication, the vast majority of genetic variants in a given individual will be unrelated to the reason the test was performed, and thus could be considered "incidental" or "secondary" findings. Of these, nearly all will have minimal or no clinical implications, but each individual will have a heterogeneous assortment of clinically significant but unpredictable genetic variants
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