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# Review status in ClinVar

Review status

Definition

ClinVar reports the level of review supporting the assertion of clinical significance for the variation as review status. Stars provide a graphical representation of the aggregate review status on web pages. Table 1 provides definitions of each review status and the corresponding number of stars. Review status is reported in text format in ClinVar's products available by ftp.


Table 1. The review status and assignment of stars

Number of gold stars Review status Description
four practice guideline practice guideline
three reviewed by expert panel reviewed by expert panel
two criteria provided, multiple submitters, no conflicts Two or more submitters with assertion criteria and evidence (or a public contact) provided the same interpretation.
one criteria provided, conflicting interpretations Multiple submitters provided assertion criteria and evidence (or a public contact) but there are conflicting interpretations. The independent values are enumerated for clinical significance.
one criteria provided, single submitter One submitter provided an interpretation with assertion criteria and evidence (or a public contact).
none no assertion for the individual variant The allele was not interpreted directly in any submission; it was submitted to ClinVar only as a component of a haplotype or a genotype.
none no assertion criteria provided The allele was included in a submission with an interpretation but without assertion criteria and evidence (or a public contact).
none no assertion provided The allele was included in a submission that did not provide an interpretation.

Each record in ClinVar is assigned a review status, including:

  • SCVs, or submitted records
  • VCVs, or aggregate variant records (equivalent to the Variation ID)
  • RCVs, or aggregate variant-disease records

The review status for a submitted record (SCV) is determined as follows:

  • Criteria provided, single submitter: this status is achieved by providing assertion criteria and supporting evidence (or a public contact). Read more details about meeting the requirements for this status.
  • Expert panel or practice guideline: this status is achieved by the organization first being approved by ClinGen. Interested organizations are encouraged to contact ClinGen early in the application process.

The review status for an aggregate VCV or RCV record depends on data provided in all of the contributing SCVs:

  1. whether any submission provided assertion criteria and evidence (or a public contact)
  2. whether the submissions agree on the interpretation
  3. the review status from an expert panel or a practice guideline submission becomes the review status for the corresponding aggregate VCV or RCV record

Web display

The aggregate review status for the VCV record is displayed on the variation report as shown in Figure 1. Gold stars are also used to represent the aggregate review status on web pages. Note that there are multiple review statuses represented by zero and one stars; see the correlation between review status and stars above.


Figure 1. Aggregate review status for a VCV record.

Display of review status in the interpretation section

FTP

The review status is included in FTP files as shown in Table 2.


Table 2. The review status in ClinVar's FTP files

File How review status is reported
ClinVarFullRelease XML Review status for the RCV is reported as:

<ReferenceClinVarAssertion>
...
<ClinicalSignificance>
<ReviewStatus>criteria provided, single submitter</ReviewStatus>
</ClinicalSignificance>
...
</ReferenceClinVarAssertion>

Review status for the SCV is reported as:

<ClinVarAssertion>
...
<ClinicalSignificance>
; <ReviewStatus>criteria provided, single submitter</ReviewStatus>
</ClinicalSignificance>
...
</ClinVarAssertion>

ClinVarVariationRelease XML Review status for the VCV is reported as:

<InterpretedRecord>
...
<ReviewStatus>criteria provided, single submitter</ReviewStatus>
...
</InterpretedRecord>

Review status for the SCV is reported as:

<InterpretedRecord>
...
<ClinicalAssertionList>
<ClinicalAssertion>
...
<ReviewStatus>criteria provided, single submitter</ReviewStatus>
...
</ClinicalAssertion>
</ClinicalAssertionList>
...
</InterpretedRecord>

VCF New VCF files (VCF 2.0) report review status for the Variation ID in the CLNREVSTAT INFO tag.
Old VCF files reported review status for each RCV for the rs ID in the CLNREVSTAT INFO tag.
variant_summary.txt The ReviewStatus column reports the highest review status for each variant.
summary_of_conflicting_interpretations.txt The review status for each of a pair of conflicting submissions is reported as Submitter1_ReviewStatus and Submitter2_ReviewStatus.
submission_summary.txt The review status for each submission is reported as ReviewStatus.

Assertion criteria

Definition

Assertion criteria refers to a citation (PubMed ID, PubMedCentral ID, or DOI) or an electronic document (a Word document or PDF) that describes:

  • the variant classification terms used by the submitter (e.g. pathogenic, uncertain significance, benign, or appropriate terms for other types of variation) and
  • the criteria required to assign a variant to each category

This document describes the categories and criteria that are used by the submitter to guide their classification process, not the specific evidence for an individual variant classification. This document is made available to ClinVar users on Clinvar web displays.

Note that when assertion criteria are provided, it is presumed that the submitter attests that the variant was classified according to a comprehensive review of evidence consistent with, or more thorough than, current practice guidelines. Read more details about meeting the requirements for the "criteria provided, single submitter" review status.

Representative documentation of assertion criteria

Table 3 provides examples to help submitters understand what is meant by documentation of assertion criteria and to guide you in creating your own documentation for your specific assertion criteria. These example documents are not intended to be submitted to ClinVar by other groups; please do not include either of these documents in your submission (unless your group provided the sample documentation).


Table 3. Examples of submitted assertion criteria.

Type of documentation Example
Assertion criteria GeneDx Variant Classification Process June 2021
Expert panel 2013-08_InSiGHT_VIC_v1.9.pdf

How to provide new assertion criteria

For a citation:

  • Wizard or file submission: in the ClinVar Submission Portal, on the submission's "Assertion method" tab, select the option to "use a new assertion criteria".
  • API submission: a citation is provided in the JSON, as described in the API documentation.

For a file:

Files for assertion criteria are uploaded independent of submissions. On your organization's landing page in the ClinVar Submission Portal use the button "View/add assertion criteria files" below your organization's name to upload a new file. ClinVar generates a URL to make the file publicly accessible on ClinVar web displays.

Some recommendations to name your assertion criteria file:

  • use an informative name, including the name of your organization
  • include a version number or a date; assertion criteria are likely to be updated over time and ClinVar requires distinct names for distinct files
  • if you have multiple documents for different scenarios, for example one document for autosomal recessive variants and one for autosomal dominant variants, include that information in the name
  • if your methods are published but not open access, please excerpt the variant interpretation methods from the publication and submit with reference to the full publication

How to specify assertion criteria for your submission

Wizard or file submission: in the ClinVar Submission Portal, on the submission's "Assertion method" tab:

  • select the option to "use one of my existing assertion criteria"
  • choose the desired citation or file

API submission: a citation or URL for a file already uploaded in the Submission Portal is provided in the JSON, as described in the API documentation.

A submission must reference one set of assertion criteria only, and these criteria must apply to every variant classification in the submission.

Remember that the review status of "criteria provided, single submitter" requires this documentation AND either the evidence for each interpretation OR a public contact for your organization.

Web display

Links to assertion criteria for each submission are displayed on the Variation ID pages in the "Submitted interpretations and evidence" section of the "Variant details" tab as shown in Figure 2.


Figure 2. Links to assertion criteria on a VCV record.

Display of review status in the evidence section

Assertion criteria can also be accessed per organization on each submitter page as shown in Figure 3.


Figure 3. An example of a submitter page with links to assertion criteria for that organization.

Display of an organization page with assertion criteria

FTP

Assertion criteria are availabe in the RCV and VCV XML files as shown in Table 4.

Table 4. Assertion criteria in ClinVar's FTP files.

File

How assertion criteria is reported

ClinVarFullRelease XML Assertion criteria for each submitted record (SCV) is reported as:

<ClinVarAssertion>
...
<AttributeSet>
<Attribute Type="AssertionMethod">Ambry Autosomal Dominant and X-Linked criteria (10/2015)</Attribute>
<Citation>
<URL>https://submit.ncbi.nlm.nih.gov/ft/byid/aH4uL7vL/mid-7377_ambry_classification_scheme_oct_2015.pdf</URL>
</Citation>
</AttributeSet>
...
</ClinVarAssertion>
ClinVarVariationRelease XML
Assertion criteria for each submitted (SCV) is reported as:

<ClinicalAssertion>
...
<AttributeSet>
<Attribute Type="AssertionMethod">Ambry Autosomal Dominant and X-Linked criteria (10/2015)</Attribute>
<Citation>
<URL>https://submit.ncbi.nlm.nih.gov/ft/byid/aH4uL7vL/mid-7377_ambry_classification_scheme_oct_2015.pdf</URL>
</Citation>
</AttributeSet>
...
</ClinicalAssertion>

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Last updated: 2022-11-22T17:26:13Z