Hypothesis generation for rare and undiagnosed diseases through clustering and classifying time-versioned biological ontologies

Rare diseases affect 1-in-10 people in the United States and despite increased genetic testing, up to half never receive a diagnosis. Even when using advanced genome sequencing platforms to discover variants, if there is no connection between the variants found in the patient’s genome and their phe-notypes in the literature, then the patient will remain undiagnosed. When a direct variant-phenotype connection is not known, putting a patient’s information in the larger context of phenotype relation-ships and protein-protein-interactions may provide an opportunity to find an indirect explanation. Databases such as STRING contain millions of protein-protein-interactions and HPO contains the relations of thousands of phenotypes. By integrating these networks and clustering the entities within we can potentially discover latent gene-to-phenotype connections. The historical records for STRING and HPO provide a unique opportunity to create a network time series for evaluating the cluster sig-nificance. Most excitingly, working with Children’s Hospital Colorado we provide promising hy-potheses about latent gene-to-phenotype connections for 38 patients with undiagnosed diseases. We also provide potential answers for 14 patients listed on MyGene2. Clusters our tool finds significant harbor 2.35 to 8.72 times as many gene-to-phenotypes edges inferred from known drug interactions than clusters find to be insignificant. Our tool, BOCC, is available as a web app and command line tool. ### Competing Interest Statement The authors have declared no competing interest.