CAGI, the Critical Assessment of Genome Interpretation, establishes progress and prospects for computational genetic variant interpretation methods

The Critical Assessment of Genome Interpretation (CAGI) aims to advance the state of the art for computational prediction of genetic variant impact, particularly those relevant to disease. The five complete editions of the CAGI community experiment comprised 50 challenges, in which participants made blind predictions of phenotypes from genetic data, and these were evaluated by independent assessors. Overall, results show that while current methods are imperfect, they have major utility for research and clinical applications. Missense variant interpretation methods are able to estimate biochemical effects with increasing accuracy. Performance is particularly strong for clinical pathogenic variants, including some difficult-to-diagnose cases, and extends to interpretation of cancer-related variants. Assessment of methods for regulatory variants and complex trait disease risk is less definitive, and indicates performance potentially suitable for auxiliary use in the clinic. Emerging methods and increasingly large, robust datasets for training and assessment promise further progress ahead.