itmenon College 01 Medical Genetics and Genomics Genetics ACMG POLICY STATEMENT inMedicine ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing Robert C. Green, MD, MPhlu, Jonathan S. Berg, MD, PhD3, Wayne W. Grody, MD, PhD", Sarah S. Kalia, ScM, CGC', Bruce R. Korf, MD, PhD7, Christa L. Martin, PhD, FACMG8, Amy L. McGuire, JD, PhD°, Robert L. Nussbaum, MD10, Julianne M. O'Daniel, MS, CGC3, Kelly E. Ormond, MS, CGC", Heidi L. Rehm, PhD, FACMG412, Michael S. Watson, PhD, FACMGB, Marc S. Williams, MD, FACMG1d and Leslie G. Biesecker, MD's Disclaimer: These recommendations are designed primarily as an educational moult/ for medical geneticists and other health-care providers to help them provide quality medical genetic services. Adherence to these recommendations does not necessarily ensure a successful medical outcome. These recommendations should not be considered indusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test. geneticists and other clinicians should apply their own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these recommendations. In dinical exome and genome sequencing, there is a potential for the recognition and reporting of incidental or secondary findings unre- lated to the indication for ordering the sequencing but of medical value for patient care. The American College of Medical Genetics and Genomics (ACMG) recently published a policy statement on clinical sequencing that emphasized the importance of alerting the patient to the possibility of such results in pretest patient discussions, clini- cal testing, and reporting of results. The ACMG appointed a Work-