InpherNet provides attractive monogenic disease gene hypotheses using patient genes indirect neighbors

Close to 70% of patients suspected to have a Mendelian disease remain undiagnosed after genome sequencing, partly because our current knowledge about disease-causing genes is incomplete. Although hundreds of new diseases-causing genes are discovered every year, the discovery rate has been constant for over a decade. Generating an attractive novel disease gene hypothesis from patient data can be time-consuming as each patient’s genome can contain dozens to hundreds of rare, possibly pathogenic variants. To generate the most plausible hypothesis, many sources of indirect evidence about each candidate variant may be considered. We introduce InpherNet, a network-based machine learning approach to accelerate this process. InpherNet ranks candidate genes based on gene neighbors from 4 graphs, of orthologs, paralogs, functional pathway members, and co-localized interaction partners. As such InpherNet can be used to both prioritize potentially novel disease genes and also help reveal known disease genes where their direct annotation is missing, or partial. InpherNet is applied to over 100 patient cases for whom the causative gene is incorrectly given low priority by two clinical gene ranking methods that rely exclusively on human patient-derived evidence. It correctly ranks the causative gene among its top 5 candidates in 68% of the cases, compared to 9-44% using comparable tools including Phevor, Phive and hiPhive. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Bio-X SIGF fellowship to J.B., DARPA (G.B.), the Stanford Pediatrics Department (J.A.B., G.B.), a Packard Foundation Fellowship (G.B.), a Microsoft Faculty Fellowship (G.B.), and the Stanford Data Science Initiative (G.B). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Stanford IRB-32036 All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes A portion of the data we use is available from EGA. Another portion is of consented Stanford patients. Some of the latter can be shared while respecting consent conditions.