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PhenoScore quantifies phenotypic variation for rare genetic diseases by combining facial analysis with other clinical features using a machine-learning framework | Nature Genetics

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Nature Genetics volume  55, pages 1598–1607 (2023 )Cite this article Shr Hair Removal Machine Ipl Shr Laser

PhenoScore quantifies phenotypic variation for rare genetic diseases by combining facial analysis with other clinical features using a machine-learning framework | Nature Genetics

Several molecular and phenotypic algorithms exist that establish genotype–phenotype correlations, including facial recognition tools. However, no unified framework that investigates both facial data and other phenotypic data directly from individuals exists. We developed PhenoScore: an open-source, artificial intelligence-based phenomics framework, combining facial recognition technology with Human Phenotype Ontology data analysis to quantify phenotypic similarity. Here we show PhenoScore’s ability to recognize distinct phenotypic entities by establishing recognizable phenotypes for 37 of 40 investigated syndromes against clinical features observed in individuals with other neurodevelopmental disorders and show it is an improvement on existing approaches. PhenoScore provides predictions for individuals with variants of unknown significance and enables sophisticated genotype–phenotype studies by testing hypotheses on possible phenotypic (sub)groups. PhenoScore confirmed previously known phenotypic subgroups caused by variants in the same gene for SATB1, SETBP1 and DEAF1 and provides objective clinical evidence for two distinct ADNP-related phenotypes, already established functionally.

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The used dataset in this study is not publicly available due to both IRB and General Data Protection Regulation (EU GDPR) restrictions because the data might be (partially) traceable. However, access to the data may be requested from the data availability committee by contacting the corresponding authors via e-mail with a research proposal, who will respond within 14 d.

The code of PhenoScore version 1.0.0 created during this study is freely available at https://github.com/ldingemans/PhenoScore ref. 83, to enable anyone to apply PhenoScore to their own dataset. Included in PhenoScore are the following two examples: the data for the SATB1 subgroups (positive example) and random data (negative example).

Vissers, LELM et al.A de novo paradigm for mental retardation.Nut.Genet.42, 1109–1112 (2010).

Article  CAS  PubMed  Google Scholar 

de Ligt, J. et al. Diagnostic exome sequencing in persons with severe intellectual disability. N. Engl. J. Med. 367, 1921–1929 (2012).

Rauch, A. et al. Range of genetic mutations associated with severe non-syndromic sporadic intellectual disability: an exome sequencing study. Lancet 380, 1674–1682 (2012).

Article  CAS  PubMed  Google Scholar 

Gilissen, C. et al. Genome sequencing identifies major causes of severe intellectual disability. Nature 511, 344–347 (2014).

Article  CAS  PubMed  Google Scholar 

Richards, S. et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet. Med. 17, 405–424 (2015).

Article  PubMed  PubMed Central  Google Scholar 

Beaumont, R. N. & Wright, C. F. Estimating diagnostic noise in panel-based genomic analysis. Genet. Med. 24, 2042–2050 (2022).

Article  CAS  PubMed  Google Scholar 

McGuire, A. L. et al. The road ahead in genetics and genomics. Nat. Rev. Genet. 21, 581–596 (2020).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Logsdon, G. A., Vollger, M. R. & Eichler, E. E. Long-read human genome sequencing and its applications. Nat. Rev. Genet. 21, 597–614 (2020).

Article  CAS  PubMed  PubMed Central  Google Scholar 

100,000 Genomes Project Pilot Investigators. et al.100,000 genomes pilot on rare-disease diagnosis in health care—preliminary report. N. Engl. J. Med. 385, 1868–1880 (2021).

Neveling, K. et al. Next-generation cytogenetics: comprehensive assessment of 52 hematological malignancy genomes by optical genome mapping. Am. J. Hum. Genet. 108, 1423–1435 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Mantere, T. et al. Optical genome mapping enables constitutional chromosomal aberration detection. Am. J. Hum. Genet. 108, 1409–1422 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Schwarz, J. M., Rödelsperger, C., Schuelke, M. & Seelow, D. MutationTaster evaluates disease-causing potential of sequence alterations. Nat. Methods 7, 575–576 (2010).

Article  CAS  PubMed  Google Scholar 

Adzhubei, I. A. et al. A method and server for predicting damaging missense mutations. Nat. Methods 7, 248–249 (2010).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kumar, P., Henikoff, S. & Ng, P. C. Predicting the effects of coding non-synonymous variants on protein function using the SIFT algorithm. Nat. Protoc. 4, 1073–1081 (2009).

Article  CAS  PubMed  Google Scholar 

Kircher, M. et al. A general framework for estimating the relative pathogenicity of human genetic variants. Nat. Genet. 46, 310–315 (2014).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Robinson, P. N. et al. The Human Phenotype Ontology: a tool for annotating and analyzing human hereditary disease. Am. J. Hum. Genet. 83, 610–615 (2008).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Leite, A. J. D. C. et al. Diagnostic yield of patients with undiagnosed intellectual disability, global developmental delay and multiples congenital anomalies using karyotype, microarray analysis, whole exome sequencing from Central Brazil. PLoS ONE 17, e0266493 (2022).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Clift, K. et al. Patients’ views on variants of uncertain significance across indications. J. Community Genet. 11, 139–145 (2020).

Makhnoon, S., Garrett, L. T., Burke, W., Bowen, D. J. & Shirts, B. H. Experiences of patients seeking to participate in variant of uncertain significance reclassification research. J. Community Genet. 10, 189–196 (2019).

Van Dijk, S. et al. Clinical characteristics affect the impact of an uninformative DNA test result: the course of worry and distress experienced by women who apply for genetic testing for breast cancer. J. Clin. Oncol. 24, 3672–3677 (2006).

Murray, M. L., Cerrato, F., Bennett, R. L. & Jarvik, G. P. Follow-up of carriers of BRCA1 and BRCA2 variants of unknown significance: variant reclassification and surgical decisions. Genet. Med. 13, 998–1005 (2011).

Article  CAS  PubMed  Google Scholar 

Hamburg, M. A. & Collins, F. S. The path to personalized medicine. N. Engl. J. Med. 363, 301–304 (2010).

Article  CAS  PubMed  Google Scholar 

Ashley, E. A. Towards precision medicine. Nat. Rev. Genet. 17, 507–522 (2016).

Article  CAS  PubMed  Google Scholar 

Brittain, H. K., Scott, R. & Thomas, E. The rise of the genome and personalised medicine. Clin. Med. 17, 545–551 (2017).

Coudray, N. et al. Classification and mutation prediction from non-small cell lung cancer histopathology images using deep learning. Nat. Med. 24, 1559–1567 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hosny, A., Parmar, C., Quackenbush, J., Schwartz, L. H. & Aerts, H. J. W. L. Artificial intelligence in radiology. Nat. Rev. Cancer 18, 500–510 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Killock, D. AI outperforms radiologists in mammographic screening. Nat. Rev. Clin. Oncol. 17, 134 (2020).

Lu, M. Y. et al. AI-based pathology predicts origins for cancers of unknown primary. Nature 594, 106–110 (2021).

Article  CAS  PubMed  Google Scholar 

Poplin, R. et al. A universal SNP and small-indel variant caller using deep neural networks. Nat. Biotechnol. 36, 983–987 (2018).

Article  CAS  PubMed  Google Scholar 

Sundaram, L. et al. Predicting the clinical impact of human mutation with deep neural networks. Nat. Genet. 50, 1161–1170 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wick, R. R., Judd, L. M. & Holt, K. E. Performance of neural network basecalling tools for Oxford Nanopore sequencing. Genome Biol. 20, 129 (2019).

Article  PubMed  PubMed Central  Google Scholar 

Köhler, S. et al. Clinical diagnostics in human genetics with semantic similarity searches in ontologies. Am. J. Hum. Genet. 85, 457–464 (2009).

Article  PubMed  PubMed Central  Google Scholar 

Robinson, P. N. et al. Improved exome prioritization of disease genes through cross-species phenotype comparison. Genome Res. 24, 340–348 (2014).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zemojtel, T. et al. Effective diagnosis of genetic disease by computational phenotype analysis of the disease-associated genome. Sci. Transl. Med. 6, 252ra123 (2014).

Article  PubMed  PubMed Central  Google Scholar 

Smedley, D. & Robinson, P. N. Phenotype-driven strategies for exome prioritization of human Mendelian disease genes. Genome Med. 7, 81 (2015).

Article  PubMed  PubMed Central  Google Scholar 

Smedley, D. et al. Next-generation diagnostics and disease-gene discovery with the Exomiser. Nat. Protoc. 10, 2004–2015 (2015).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hsieh, T.-C. et al. PEDIA: prioritization of exome data by image analysis. Genet. Med. 21, 2807–2814 (2019).

Article  PubMed  PubMed Central  Google Scholar 

Robinson, P. N. et al. Interpretable clinical genomics with a likelihood ratio paradigm. Am. J. Hum. Genet. 107, 403–417 (2020).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ferry, Q. et al. Diagnostically relevant facial gestalt information from ordinary photos. eLife 3, e02020 (2014).

Article  PubMed  PubMed Central  Google Scholar 

Dudding-Byth, T. et al. Computer face-matching technology using two-dimensional photographs accurately matches the facial gestalt of unrelated individuals with the same syndromic form of intellectual disability. BMC Biotechnol. 17, 90 (2017).

Article  PubMed  PubMed Central  Google Scholar 

Van der Donk, R. et al. Next-generation phenotyping using computer vision algorithms in rare genomic neurodevelopmental disorders. Genet. Med. 21, 1719–1725 (2019).

Gurovich, Y. et al. Identifying facial phenotypes of genetic disorders using deep learning. Nat. Med. 25, 60–64 (2019).

Article  CAS  PubMed  Google Scholar 

Dingemans, AJM et al. Quantitative facial phenotyping for Koolen-de Vries and 22q11.2 deletion syndrome.EUR.J. Hum.Genet.29, 1418–1423 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hsieh, T.-C. et al. GestaltMatcher facilitates rare disease matching using facial phenotype descriptors. Nat. Genet. 54, 349–357 (2022).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Claes, P. et al. Genome-wide mapping of global-to-local genetic effects on human facial shape. Nat. Genet. 50, 414–423 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

White, J. D. et al. Insights into the genetic architecture of the human face. Nat. Genet. 53, 45–53 (2021).

Article  CAS  PubMed  Google Scholar 

Naqvi, S. et al. Shared heritability of human face and brain shape. Nat. Genet. 53, 830–839 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhang, M. et al. Genetic variants underlying differences in facial morphology in East Asian and European populations. Nat. Genet. 54, 403–411 (2022).

Article  CAS  PubMed  Google Scholar 

Vulto-van Silfhout, A. T. et al. Clinical significance of de novo and inherited copy-number variation. Hum. Mutat. 34, 1679–1687 (2013).

Article  CAS  PubMed  Google Scholar 

Brier, G. W. Verification of forecasts expressed in terms of probability. Mon. Weather Rev. 78, 1–3 (1950).

Koolen, D. A. et al. Mutations in the chromatin modifier gene KANSL1 cause the 17q21.31 microdeletion syndrome. Nat. Genet. 44, 639–641 (2012).

Article  CAS  PubMed  Google Scholar 

Zollino, M. et al. Mutations in KANSL1 cause the 17q21.31 microdeletion syndrome phenotype. Nat. Genet. 44, 636–638 (2012).

Article  CAS  PubMed  Google Scholar 

Koolen, D. A. et al. The Koolen-de Vries syndrome: a phenotypic comparison of patients with a 17q21.31 microdeletion versus a KANSL1 sequence variant. Eur. J. Hum. Genet. 24, 652–659 (2016).

Article  CAS  PubMed  Google Scholar 

Köhler, S. et al. Expansion of the Human Phenotype Ontology (HPO) knowledge base and resources. Nucleic Acids Res. 47, D1018–D1027 (2019).

den Hoed, J. et al. Mutation-specific pathophysiological mechanisms define different neurodevelopmental disorders associated with SATB1 dysfunction. Am. J. Hum. Genet. 108, 346–356 (2021).

Nabais Sá, M. J. et al. De novo and biallelic DEAF1 variants cause a phenotypic spectrum. Genet. Med. 21, 2059–2069 (2019).

Hoischen, A. et al.De novo mutations of SETBP1 cause Schinzel-Giedion syndrome.Nat.Genet.42, 483–485 (2010).

Article  CAS  PubMed  Google Scholar 

Filges, I. et al. Reduced expression by SETBP1 haploinsufficiency causes developmental and expressive language delay indicating a phenotype distinct from Schinzel-Giedion syndrome. J. Med. Genet. 48, 117–122 (2011).

Article  CAS  PubMed  Google Scholar 

Bend, E. G. et al. Gene domain-specific DNA methylation episignatures highlight distinct molecular entities of ADNP syndrome. Clin. Epigenetics 11, 64 (2019).

Article  PubMed  PubMed Central  Google Scholar 

Breen, M. S. et al. Episignatures stratifying Helsmoortel-Van Der Aa syndrome Show modest correlation with phenotype. Am. J. Hum. Genet. 107, 555–563 (2020).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jagadeesh, K. A. et al. Phrank measures phenotype sets similarity to greatly improve Mendelian diagnostic disease prioritization. Genet. Med. 21, 464–470 (2019).

Article  CAS  PubMed  Google Scholar 

Lyra Jr, P. C. M. et al. Integration of functional assay data results provides strong evidence for classification of hundreds of BRCA1 variants of uncertain significance. Genet. Med. 23, 306–315 (2021).

Article  CAS  PubMed  Google Scholar 

Frederiksen, J. H., Jensen, S. B., Tümer, Z. & Hansen, T. V. O. Classification of MSH6 variants of uncertain significance using functional assays. Int. J. Mol. Sci. 22, 8627 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Caswell, R. C., Gunning, A. C., Owens, M. M., Ellard, S. & Wright, C. F. Assessing the clinical utility of protein structural analysis in genomic variant classification: experiences from a diagnostic laboratory. Genome Med. 14, 77 (2022).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Dingemans, A. J. M. et al. Human disease genes website series: an international, open and dynamic library for up-to-date clinical information. Am. J. Med. Genet. A 185, 1039–1046 (2021).

Article  PubMed  PubMed Central  Google Scholar 

McKusick, V. A. Mendelian inheritance in man and its online version, OMIM. Am. J. Hum. Genet. 80, 588–604 (2007).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Firth, H. V. et al. DECIPHER: database of chromosomal imbalance and phenotype in humans using ensembl resources. Am. J. Hum. Genet. 84, 524–533 (2009).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Adam, MP et al.GeneReviews (University of Washington, 2010).

Helsmoortel, C. et al. A SWI/SNF-related autism syndrome caused by de novo mutations in ADNP. Nat. Genet. 46, 380–384 (2014).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Côté, R. A. & Robboy, S. Progress in medical information management. Systematized nomenclature of medicine (SNOMED). JAMA 243, 756–762 (1980).

Karras, T., Laine, S. & Aila, T. A style-based generator architecture for generative adversarial networks. IEEE Trans. Pattern Anal. Mach. Intell. 43, 4217–4228 (2021).

Manders, P., Lutomski, J. E., Smit, C., Swinkels, D. W. & Zielhuis, G. A. The Radboud biobank: a central facility for disease-based biobanks to optimise use and distribution of biomaterial for scientific research in the Radboud university medical center, Nijmegen. Open J. Bioresour. 5, 2 (2018).

Parkhi, O. M., Vedaldi, A. & Zisserman, A. Deep face recognition. Proceedings of the British Machine Vision Conference (eds Xianghua X. et al.) 41.1–41.12 (BMVA Press, 2015).

Cao, Q. Shen, L., Xie, W. Parkhi, O. M. & Zisserman, A. VGGFace2: a dataset for recognising faces across pose and age. Proceedings of 13th IEEE International Conference on Automatic Face & Gesture Recognition (F&G) pp. 67–74 (IEEE, 2018).

Dingemans, A. J. M., de Vries, B. B. A., Vissers, L. E. L., van Gerven, M. A. J. & Hinne, M. Comparing facial feature extraction methods in the diagnosis of rare genetic syndromes. Preprint at medRxiv https://doi.org/10.1101/2022.08.26.22279217 (2022).

Resnik, P. Semantic similarity in a taxonomy: an information-based measure and its application to problems of ambiguity in natural language. J. Artif. Intell. Res. 11, 95–130 (1999).

Pesquita, C. et al. Metrics for GO based protein semantic similarity: a systematic evaluation. BMC Bioinformatics 9, S4 (2008).

Article  PubMed  PubMed Central  Google Scholar 

Arvai, K., Gainullin, V. & Borroto, C. GeneDx/phenopy.Zenodo https://doi.org/10.5281/zenodo.4587231 (2019).

Ribeiro, M. T., Singh, S. & Guestrin, C. ‘Why should I trust you?’ Explaining the predictions of any classifier. Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and DATA MINIng 1135–1144 (Association for Computing Machinery, 2016).

Ras, G., Xie, N., van Gerven, M. & Doran, D. Explainable deep learning: a field guide for the uninitiated. J. Artif. Intell. Res. 73, 329–396 (2022).

Köhler, S. et al. The human phenotype ontology in 2017. Nucleic Acids Res. 45, D865–D876 (2017).

Yuan, X. et al. Evaluation of phenotype-driven gene prioritization methods for Mendelian diseases. Brief. Bioinform. 23, bbac019 (2022).

Article  PubMed  PubMed Central  Google Scholar 

Dingemans, L. ldingemans/PhenoScore: v1.0.0.Zenodo https://doi.org/10.5281/zenodo.7892317 (2023).

We are grateful to all families and clinicians who agreed to participate and provide clinical and genotypic information. R.F.K. acknowledges financial support from the Research Fund of the University of Antwerp (Methusalem-OEC grant GENOMED). The work of G.J.L. is supported by New York State Office for People with Developmental Disabilities (OPWDD) and NIH NIGMS R35-GM-133408. E.E.P. is supported by a National Health and Medical Research Council Investigator Grant (award 2021/GNT2008166). Furthermore, we are grateful to the Dutch Organization for Health Research and Development—ZON-MW grants 912-12-109 (to B.B.A.d.V. and L.E.L.M.V.), Donders Junior researcher grant 2019 (to B.B.A.d.V. and L.E.L.M.V.) and Aspasia grant 015.014.066 (to L.E.L.M.V.). The aims of this study contribute to the Solve-RD project (to L.E.L.M.V.), which has received funding from the European Unions Horizon 2020 research and innovation program under grant agreement 779257. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

These authors contributed equally: Lisenka E. L. M. Vissers, Bert B. A. de Vries.

Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands

Alexander JM Dingemans, Kim MG Truijen, Lia Goltstein, Jeroen van Reeuwijk, Nicole de Leeuw, Janneke Schuurs-Hoeijmakers, Rolph Pfundt, Illja J. Diets, Elke de Boer, Jet Coenen-van der Spek, Bregje W. van Bon, Noraly Jonis, Charlotte W. Ockeloen, Anneke T. Vulto-van Silfhout, Tjitske Kleefstra, David A. Koolen, Lisenka ELM Vissers & Bert BA de Vries

Department of Artificial Intelligence, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands

Alexander JM Dingemans, Max Hinne & Marcel AJ van Gerven

Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands

Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada

Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia

Sydney Children’s Hospitals Network, Sydney, New South Wales, Australia

Center for Human Genetics, University Hospitals Leuven, University of Leuven, Leuven, Belgium

Department of Human Genetics and George A. Jervis Clinic, Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA

Biology PhD Program, The Graduate Center, The City University of New York, New York City, NY, USA

Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Institute of Medical Genetics, University of Zürich, Zürich, Switzerland

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA

Faculty of Medicine, University of Southampton, Southampton, UK

Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands

Pleuntje J. van der Sluijs & Gijs WE Santen

Department of Medical Genetics, University of Antwerp, Antwerp, Belgium

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A.J.M.D., M.H., L.E.L.M.V., B.B.A.d.V. and M.A.J.v.G. designed the study. A.J.M.D., K.M.G.T., L.G., J.v.R., N.d.L., J.S.H., R.P., I.J.D., E.d.B., J.d.H., J.v.d.S., S.J., B.W.v.B., N.J., E.E.P., P.M.C., A.T.V.v.S., T.K., D.A.K., F.K., H.V.E., G.J.L., F.S.A., A.R., R.M., D.B., P.J.v.d.S., G.S., L.E.L.M.V. and B.B.A.d.V. collected and curated the data. A.J.M.D. and M.H. performed the formal analyses. L.E.L.M.V. and B.B.A.d.V. acquired the funding. A.J.M.D. and M.H. completed the modeling and investigations. A.J.M.D. developed the software. A.J.M.D., M.H., L.E.L.M.V., B.B.A.d.V. and M.A.J.v.G. wrote the original draft. All authors reviewed and edited the final manuscript.

Correspondence to Lisenka E. L. M. Vissers or Bert B. A. de Vries.

The authors declare no competing interests.

Nature Genetics thanks Xinran Dong and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The predictive accuracies of LIRICAL, Phenomizer and PhenoScore [118-120] for every included genetic syndrome are displayed here, except for ACTL6A, since the associated phenotype has no OMIM number and therefore Phenomizer and LIRICAL do not include it in its predictions. For PhenoScore and LIRICAL, to calculate the accuracy, a cut-off value of 0.5 for the predictions was used, while for Phenomizer in this case, 0.05 was chosen. For almost every investigated syndrome, PhenoScore outperforms Phenomizer and LIRICAL.

The receiver operating characteristic curve of all 40 genetic syndromes included in this study.

The Uniform Manifold Approximation and Projection for Dimension Reduction (UMAP3) plot for the VGGFace2 vectors of all included genetic syndromes, and for the extra systematic confounder analysis for which the individuals with Koolen-de Vries syndrome seen at other centers were compared to individuals seen at our outpatient clinic. For all plots (except the KANSL1 internal/external plot), the feature vectors of all sampled controls during five iterations and the feature vectors of the included patients were provided as input to UMAP. The classes are not separable in this projected space, which provides evidence that the classification is not based on a systematic confounder.

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Dingemans, A.J.M., Hinne, M., Truijen, K.M.G. et al. PhenoScore quantifies phenotypic variation for rare genetic diseases by combining facial analysis with other clinical features using a machine-learning framework. Nat Genet 55, 1598–1607 (2023). https://doi.org/10.1038/s41588-023-01469-w

DOI: https://doi.org/10.1038/s41588-023-01469-w

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PhenoScore quantifies phenotypic variation for rare genetic diseases by combining facial analysis with other clinical features using a machine-learning framework | Nature Genetics

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