White labcorp logo

Exciting news: Invitae joins Labcorp to expand the future of genetic testing. Learn more

Clinical practice resources

Genetic test results can be critical to patient care plans—but they’re just one component of your busy practice. Invitae’s clinical practice resources can help you identify when testing should be considered, educate patients on the purpose of genetic testing, test options, and potential results, and answer common questions.

Gene-specific medical management

Genetic information is complex, and it is not always easy to understand what test results mean or the appropriate actions for individuals who test positive. The Invitae® result guides were developed by experts and are based on standard medical management guidelines and published data. The positive result guides below are labeled by gene and number of variants, or specific variant(s). It is important to review these details on a test report carefully.

  • 1 variant specifies a gene result with a single pathogenic or likely pathogenic variant. It would also apply to 2 or more variants that are on the same chromosome (ie, inherited from the same parent). These guides only apply when the variant is associated with autosomal dominant risk, unless otherwise noted as a "carrier" or "benign reportable variant" result guide.
  • 2 variants specifies a gene result with two pathogenic or likely pathogenic variants, on opposite chromosomes (ie, one from each parent). This may be two of the same variant (homozygous) or two different variants in the gene (each called heterozygous).
  • These guides may not be appropriate for “potentially positive” or “positive possibly mosaic” results, or for results that are suspected to be blood-limited or part of a larger imbalance of genetic material (copy number variant)

These guides are automatically appended to reports, unless you choose to exclude them by logging in to your Invitae account and visiting the settings page. Of note, these result guides are general and are not specific to an individual’s genetic test result or personal and family history. They do not represent medical advice and are meant to be used to support care provided by a healthcare provider. They are intended to be a resource for starting the conversation about what to do next. We strive to keep these guides up to date with the most recent medical information, but healthcare providers should always refer to current guidelines and recommendations when considering surveillance and treatment options. In addition, these guides may not include all relevant international recommendations.

† Translation of certain positive result guides into French are available on this webpage. Additional translated versions are not available at this time. Product feedback requests can be sent to: product-feedback@invitae.com

References

1. Isselbacher EM, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022;146(24):e334-e482.
2. Wilde AAM, et al. European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society Expert Consensus Statement on the State of Genetic Testing for Cardiac Diseases. Heart Rhythm. 2022;19(7):e1-360.
3. Stiles MK, et al. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. Heart Rhythm. 2021;18(1):e1-e50.
4. Dellefave-Castillo LM, et al. Assessment of the Diagnostic Yield Combined Cardiomyopathy Arrhythmia Genetic Testing. JAMA Cardiol. 2022;7(9):966-74.
5. Towbin JA, et al. 2019 HRS Expert Consensus Statement on Evaluation, Risk Stratification, and Management of Arrhythmogenic Cardiomyopathy. Heart Rhythm. 2019;16(11):e373-e407.
6. Ommen SR, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. Published online May 8, 2024.
7. Sturm AC, et al. Clinical Genetic Testing for Familial Hypercholesterolemia: JACC Scientific Expert Panel. J Am Coll Cardiol. 2018;72(6):662-80.
8. Hegele RA, et al. Rare dyslipidaemias, from phenotype to genotype to management: a European Atherosclerosis Society task force consensus statement. Lancet Diabetes Endocrinol. 2020;8(1):50-67.
9. Watts GF, et al. Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation. Int J Cardiol. 2014;171(3):309-25.
10. Czerny M, Grabenwöger M, Berger T, et al. EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. Ann Thorac Surg. 2024. Published online February 22, 2024.
11. Unger S, Ferreira CR, Mortier GR, et al. Nosology of genetic skeletal disorders: 2023 revision. Am J Med Genet A. 2023;191(5):1164-1209.
12. Smith L, et al. Genetic testing and counseling for the unexplained epilepsies: An evidence-based practice guideline of the National Society of Genetic Counselors. J Genet Couns. 2022;online ahead of print.
13. Moeschler JB, et al. Clinical genetic evaluation of the child with intellectual disability or developmental delays. Pediatrics. 2014;134(3):e903-18.
14. Albanese A, et al. EFNS guidelines on diagnosis and treatment of primary dystonias. Eur J Neurol. 2011;18(1):5-18.
15. Narayanaswami P, et al. Evidence-based guideline summary: diagnosis and treatment of limb-girdle and distal dystrophies: report of the guideline development subcommittee of the American Academy of Neurology and the practice issues review panel of the American Association of Neuromuscular & Electrodiagnostic Medicine. Neurology. 2014;83(16):1453-63.
16. Tawil R, et al. Evidence-based guideline summary: Evaluation, diagnosis, and management of facioscapulohumeral muscular dystrophy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine. Neurology. 2015;85(4):357-64.
17. Kang PB, et al. Evidence-based guideline summary: evaluation, diagnosis, and management of congenital muscular dystrophy: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine. Neurology. 2015;84(13):1369-78.
18. England JD, et al. Practice Parameter: evaluation of distal symmetric polyneuropathy: role of laboratory and genetic testing (an evidence-based review). Report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology. 2009;72(2):185-92.
19. Ducharme S, et al. Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders. Brain. 2020;143(6):1632-50.
20. Berardelli A, et al. EFNS/MDS-ES/ENS recommendations for the diagnosis of Parkinson's disease. Eur J Neurol. 2013;20(1):16-34.
21. Sorbi S, et al. EFNS-ENS Guidelines on the diagnosis and management of disorders associated with dementia. Eur J Neurol. 2012;19(9):1159-79.
22. Mancuso M, et al. Monogenic cerebral small-vessel diseases: diagnosis and therapy. Consensus recommendations of the European Academy of Neurology. Eur J Neurol. 2020;27(6):909-27.
23. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalagia. 2018;38(1):1-211.
24. Manickam K, et al. Exome and genome sequencing for pediatric patients with congenital anomalies or intellectual disability: an evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2021;23(11):2029-37.
25. Smith L, et al. Genetic testing and counseling for the unexplained epilepsies: An evidence-based practice guideline of the National Society of Genetic Counselors. J Genet Couns. 2022;online ahead of print.
26. Hyman S, et al. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447.
27. Manning M, et al. Array-based technology and recommendations for utilization in medical genetics practice for detection of chromosomal abnormalities. Genet Med. 2010;12(11):742-5.
28. Mintz CS, et al. Focused Revision: ACMG practice resource: Genetic evaluation of short stature. Genet Med. 2021;23(5):813-5.
29. Cherry AM, et al. Diagnostic cytogenetic testing following positive noninvasive prenatal screening results: a clinical laboratory practice resource of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2017;19(8):845-50.
30. Savarirayan R, Rossiter JP, Hoover-Fong JE, et al. Best practice guidelines regarding prenatal evaluation and delivery of patients with skeletal dysplasia. Am J Obstet Gynecol. 2018;219(6):545-562.
31. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on haemochromatosis. J Hepatol. 2022;77(2):479-502.
32. Manahan ER, et al. Consensus Guidelines on Genetic Testing for Hereditary Breast Cancer from the American Society of Breast Surgeons. Ann Surg Oncol. 2019 Oct;26(10):3025-3031.
33. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic V.2.2024. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed September 27, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
34. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Genetic/Familial High-Risk Assessment: Colorectal V.1.2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed June 2, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
35. Blair VR, et al. Hereditary diffuse gastric cancer: updated clinical practice guidelines. Lancet Oncol. 2020 Aug;21(8):e386-e397.
36. Bratslavsky G, et al. Genetic risk assessment for hereditary renal cell carcinoma: Clinical consensus statement. Cancer. 2021 Nov 1;127(21):3957-3966.
37. Baliakas P, et al. Nordic Guidelines for Germline Predisposition to Myeloid Neoplasms in Adults: Recommendations for Genetic Diagnosis, Clinical Management and Follow-up. Hemasphere. 2019 Nov 4;3(6):e321.
38. DiNardo CD, et al. Evaluation of Patients and Families With Concern for Predispositions to Hematologic Malignancies Within the Hereditary Hematologic Malignancy Clinic (HHMC). Clin Lymphoma Myeloma Leuk. 2016 Jul;16(7):417-428.e2.
39. Muth A, et al. Genetic testing and surveillance guidelines in hereditary pheochromocytoma and paraganglioma. J Intern Med. 2019 Feb;285(2):187-204.
40. Thakker RV, et al. Endocrine Society. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab. 2012 Sep;97(9):2990-3011.
41. Wells SA Jr., et al. American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015 Jun;25(6):567-610.
42. Petr EJ, Else T. Adrenocortical carcinoma (ACC): When and why should we consider germline testing? Presse Med. 2018 Jul-Aug;47(7-8 Pt 2):e119-e125.
43. Leachman SA, et al. Selection criteria for genetic assessment of patients with familial melanoma. J Am Acad Dermatol. 2009 Oct;61(4):677.e1-14.
44. Chau C, et al. Families with BAP1-Tumor Predisposition Syndrome in The Netherlands: Path to Identification and a Proposal for Genetic Screening Guidelines. Cancers (Basel). 2019 Aug 4;11(8):1114.
45. Leachman SA, et al. Identification, genetic testing, and management of hereditary melanoma. Cancer Metastasis Rev. 2017 Mar;36(1):77-90.
46. Swen JJ, et al. A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study. Lancet. 2023;401(10374):347-356.
47. Cohn I, et al. Assessment of the Implementation of Pharmacogenomic Testing in a Pediatric Tertiary Care Setting. JAMA Netw Open. 2021;4(5):e2110446.
48. Elliott LS, et al. Clinical impact of pharmacogenetic profiling with a clinical decision support tool in polypharmacy home health patients: A prospective pilot randomized controlled trial. PLoS One. 2017;12(2):e0170905.
49. Samwald M, et al. Incidence of Exposure of Patients in the United States to Multiple Drugs for Which Pharmacogenomic Guidelines Are Available. PLoS One. 2016;11(10):e0164972.
50. Clinical Pharmacogenetics Implementation Consortium (CPIC®). Accessed October 27, 2022. www.cpicpgx.org
51. U.S. FDA Table of Pharmacogenomic Associations. Accessed October 27, 2022. www.fda.gov/medical-devices/precision-medicine/table-pharmacogenetic-associations.
52. U.S. FDA Table of Pharmacogenomic Biomarkers in Drug Labeling. Accessed October 27, 2022. www.fda.gov/drugs/science-and-research-drugs/table-pharmacogenomic-biomarkers-drug-labeling
53. Haverfield EV, et al. Physician-directed genetic screening to evaluate personal risk for medically actionable disorders: a large multi-center cohort study. BMC Med. 2021;19(1):199.
54. Chinen J, et al. Practical approach to genetic testing for primary immunodeficiencies. Ann Allergy Asthma Immunol. 2019;123(5):433-439.
55. Heimall JR, et al. Use of Genetic Testing for Primary Immunodeficiency Patients. J Clin Immunol. 2018;38(3):320-329.
56. Malfait F, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017;175(1):8-26.
57. Knoers N, et al. Genetic testing in the diagnosis of chronic kidney disease: recommendations for clinical practice. Nephrol Dial Transplant. 2022;37(2):239-254.
58. Kassardjian CD, et al. The utility of genetic testing in neuromuscular disease: A consensus statement from the AANEM on the clinical utility of genetic testing in diagnosis of neuromuscular disease. Muscle Nerve. 2016;54(6):1007-1009.
59. Schaefer G, et al. Professional Practice and Guidelines Committee. Clinical genetics evaluation in identifying the etiology of autism spectrum disorders: 2013 guideline revisions. Genet Med. 2013;15(5):399-407.
60. Carter MT, et al. Genetic and metabolic investigations for neurodevelopmental disorders: position statement of the Canadian College of Medical Geneticists (CCMG). J Med Genet. 2023;60(6):523-532.
61. Verhagen JMA, et al. Expert consensus recommendations on the cardiogenetic care for patients with thoracic aortic disease and their first-degree relatives. Int J Cardiol. 2018;258:243-248.
62. Bonilla FA, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol. 2015;136(5):1186-205.e2078.
63. Akers A, et al. Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel. Neurosurgery. 2017;80(5):665-680.
64. Stout KK, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(14):e698-e800.
65. De Backer J, et al. Genetic counselling and testing in adults with congenital heart disease: A consensus document of the ESC Working Group of Grown-Up Congenital Heart Disease, the ESC Working Group on Aorta and Peripheral Vascular Disease and the European Society of Human Genetics. Eur J Prev Cardiol. 2020;27(13):1423-1435.
66. ElSayed NA, et al. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S19-S40.
67. Shapiro AJ, et al. Diagnosis of Primary Ciliary Dyskinesia. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;197(12):e24-e39.
68. Khan AA, et al. Evaluation and Management of Hypoparathyroidism Summary Statement and Guidelines from the Second International Workshop. J Bone Miner Res. 2022;37(12):2568-2585.
69. Funder JW, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916
70. Brown RJ, et al. The Diagnosis and Management of Lipodystrophy Syndromes: A Multi-Society Practice Guideline. J Clin Endocrinol Metab. 2016;101(12):4500-4511.
71. Styne DM, et al. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102(3):709-757.
72. Bilezikian JP, et al. Evaluation and Management of Primary Hyperparathyroidism: Summary Statement and Guidelines from the Fifth International Workshop. J Bone Miner Res. 2022;37(11):2293-2314.
73. Sherman S, et al. Fragile X syndrome: diagnostic and carrier testing. Genet Med. 2005;7(8):584-587.
74. Alford RL, et al. American College of Medical Genetics and Genomics guideline for the clinical evaluation and etiologic diagnosis of hearing loss. Genet Med. 2014;16(4):347-355.
75. Faughnan ME, et al. Second International Guidelines for the Diagnosis and Management of Hereditary Hemorrhagic Telangiectasia. Ann Intern Med. 2020;173(12):989-1001.
76. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032.
77. Maurer MS, et al. Expert Consensus Recommendations for the Suspicion and Diagnosis of Transthyretin Cardiac Amyloidosis. Circ Heart Fail. 2019;12(9):e006075.
78. Gertz M, et al. Avoiding misdiagnosis: expert consensus recommendations for the suspicion and diagnosis of transthyretin amyloidosis for the general practitioner. BMC Fam Pract. 2020;21(1):198.
79. Adams D, et al. Expert consensus recommendations to improve diagnosis of ATTR amyloidosis with polyneuropathy. J Neurol. 2021;268(6):2109-2122.
80. Lipska-Ziętkiewicz BS, et al. Genetic aspects of congenital nephrotic syndrome: a consensus statement from the ERKNet-ESPN inherited glomerulopathy working group. Eur J Hum Genet. 2020;28(10):1368-1378.
81. Trautmann A, et al. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol. 2020;35(8):1529-1561.
82. Savige J, et al. Guidelines for Genetic Testing and Management of Alport Syndrome. Clin J Am Soc Nephrol. 2022;17(1):143-154.
83. Savige J, et al. Consensus statement on standards and guidelines for the molecular diagnostics of Alport syndrome: refining the ACMG criteria. Eur J Hum Genet. 2021;29(8):1186-1197.
84. Stone EM, et al. Recommendations for genetic testing of inherited eye diseases: report of the American Academy of Ophthalmology task force on genetic testing. Ophthalmology. 2012;119(11):2408-2410.
85. Galiè N, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37(1):67-119.
86. Abman SH, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation. 2015;132(21):2037-2099.
87. Bacon BR, et al. American Association for the Study of Liver Diseases. Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology. 2011;54(1):328-343.
88. Morris SA, et al. Cardiovascular Management of Aortopathy in Children: A Scientific Statement From the American Heart Association. Circulation. 2024;150(11):e228-e254.
89. Mazzolai L, et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. Published online August 30, 2024.