TruthNexus
Genomic Variant Interpretation · Medical

Variant classification that doesn't go stale.

43% of ClinVar submissions are Variants of Uncertain Significance — leaving patients in diagnostic limbo while evidence accumulates. Manual classification is slow, inconsistent, and doesn't monitor the literature. Skippy Variants applies all 28 ACMG/AMP criteria programmatically using the Tavtigian Bayesian framework, and alerts you automatically when new evidence warrants reclassification.

POST /api/acmg/classify · 200 OK
BRCA1 c.5266dupC
p.Gln1756fs · Frameshift
Pathogenic
>0.9999
Posterior probability
3 / 28
Criteria met
PVS1PS3PM2+0 benign
ClinVar ×312gnomAD v4CAP/CLIA record
43%
Of ClinVar submissions are VUS
28
ACMG/AMP criteria applied per variant
2.8M+
ClinVar records indexed
CAP/CLIA
Documentation standard per classification
See It In Action

What a response looks like

Classification with Bayesian posterior, VUS reclassification alerts, and ancestry-stratified population frequency — all three in one API.

POST /api/acmg/classify · application/jsonsimulation
BRCA2c.5946delTp.Ser1982fsFrameshift
Pathogenicposterior = 0.9972
Prior 0.10 × Tavtigian Bayesian framework (PMID 29300386) · 3 criteria met
PVS1Very Strongodds 350

Predicted null variant (frameshift) in BRCA2, a gene where loss of function is an established mechanism of BRCA2-associated cancer.

PM2Moderateodds 4.33

Absent from gnomAD v4 controls (0 alleles in 807,162 chromosomes). Extremely low population frequency.

PP3Supportingodds 2.08

Multiple computational tools predict deleterious effect: CADD=37.2, REVEL=0.91, spliceAI 5′ score=0.04.

ClinVar (42 submissions)BRCA ExchangegnomAD v4ClinGen

Simulated output representative of real API responses. Tavtigian 2018 Bayesian ACMG/AMP framework. CAP/CLIA documentation per variant.

What It Does

Six capabilities. One API.

POST /api/acmg/classify

ACMG/AMP classification

All 28 criteria (PVS1, PS1–PS4, PM1–PM6, PP1–PP5, BA1, BS1–BS4, BP1–BP7) applied programmatically using the Tavtigian 2018 Bayesian framework. Every criterion documented with evidence source. Pathogenic / Likely Pathogenic / VUS / Likely Benign / Benign.

GET /api/gnomad/variant

Population frequency lookup

gnomAD v4 allele frequency by ancestry cohort — European, African, East Asian, South Asian, Latino, Ashkenazi. Ancestry-stratified output for BA1/BS1/PM2 evidence, with ACMG signal annotation returned alongside frequency data.

POST /api/gnomad/acmg-signals

gnomAD → ACMG signals

Convert raw gnomAD population frequency data directly into structured ACMG criterion signals. BA1 (>5% in any cohort), BS1 (elevated for disorder), PM2 (absent from controls) — returned as structured evidence codes ready for the classifier.

POST /api/validate

Reclassification monitoring

Continuous monitoring: when new ClinVar submissions, functional studies, or population data warrant reclassification, an alert is generated automatically. VUS → Likely Pathogenic notifications without waiting for annual manual review.

POST /api/score/bayesian

Bayesian posterior scoring

Compute the posterior probability of pathogenicity directly from ACMG criterion signals using the Tavtigian odds-of-pathogenicity product. Prior = 0.1. Thresholds: Pathogenic ≥ 0.99, Likely Pathogenic ≥ 0.90, Likely Benign ≤ 0.10.

POST /api/ancestry/audit

Ancestry equity audit

Flag variants where frequency evidence is derived predominantly from European cohorts — a known source of classification bias. Returns per-ancestry allele counts and coverage gaps to support equitable variant interpretation.

Evidence Framework

All 28 ACMG/AMP criteria. Bayesian posterior.

Implements the Tavtigian 2018 Bayesian reformulation (PMID 29300386) of the Richards 2015 ACMG/AMP guidelines (PMID 25741868). Posterior = Prior × ∏(odds for met criteria). Prior = 0.1. Thresholds: Pathogenic ≥ 0.99 · LP ≥ 0.90 · LB ≤ 0.10 · Benign ≤ 0.01.

PVS1odds 350.00
Very Strong Pathogenic

Predicted null variant (frameshift, nonsense, canonical splice) in a gene where LOF is the disease mechanism.

PS1–PS4odds 18.70
Strong Pathogenic

Same amino acid change as established pathogenic variant; de novo confirmed; well-established functional evidence; significantly elevated prevalence in cases vs controls.

PM1–PM6odds 4.33
Moderate Pathogenic

Mutational hotspot; absent from gnomAD controls (PM2); in-frame deletion in non-repeat region; novel missense at known pathogenic residue.

PP1–PP5odds 2.08
Supporting Pathogenic

Cosegregation in multiple family members; missense in low-benign-variation gene; multiple in silico tools predict deleterious.

BA1odds 0.00
Stand-alone Benign

Allele frequency >5% in gnomAD — stand-alone benign classification, no further criteria needed.

BS1–BS4 / BP1–BP7odds 18.7 / 2.08
Strong + Supporting Benign

Greater than expected frequency for disorder; observed in healthy homozygous adult; well-established functional studies show no effect; in-frame deletion in repetitive region.

The VUS problem

43% of ClinVar submissions are Variants of Uncertain Significance — leaving patients and families in diagnostic limbo while evidence accumulates in journals no lab has time to monitor.

A VUS classified today may be reclassified to Likely Pathogenic next quarter when a functional study is published. Continuous monitoring means labs are automatically notified when reclassification is warranted — without waiting for annual manual literature reviews.

Market gap — April 2025
“Fabric Genomics — the leading independent AI variant interpretation tool — was acquired by GeneDx in April 2025 and removed from the open market.”

Skippy Variants is the neutral, API-accessible alternative for genomics labs and clinical teams not operating on the GeneDx platform.

Who It's For

Labs, boards, and R&D teams

Hospital Genomics Labs
Consistent ACMG classification with full criterion documentation for clinical reporting. CAP/CLIA-aligned records per variant.
Tumor Boards
Somatic variant interpretation with oncology-context evidence from TCGA, CIViC, and COSMIC — AMP/ASCO/CAP and OncoKB tiering available.
Genetic Counselors
Rapid variant evidence synthesis with explicit uncertainty grading. Reclassification alerts mean counselors are notified when a VUS changes.
Pharma / Biotech R&D
Variant-level evidence for trial eligibility, companion diagnostic design, and regulatory filings. Ancestry equity audits for equitable evidence generation.
Regulatory

Built for clinical laboratory standards

ACMG/AMP criteria documented with explicit evidence sources per criterion code. Classification is traceable — not inferred — meeting CAP/CLIA documentation requirements for variant reporting in clinical genomics labs.

Somatic variant interpretation includes AMP/ASCO/CAP and OncoKB tiering with oncology-context evidence — relevant for FDA companion diagnostic and CDx-adjacent evidence generation.

HIPAA-ready with BAA available. Every classification produces an immutable audit record with all 28 criteria codes, sources, odds, and posterior probability.

HIPAA ReadyCAP/CLIA AlignedACMG/AMP 2015Tavtigian 2018FDA CDx Evidence
Clinical Use

Skippy Variants is a decision-support tool for qualified genomics professionals. It does not replace laboratory director review, clinical validation, or physician interpretation. All variant classifications should be confirmed against current institutional guidelines and patient-specific clinical context before reporting. HIPAA-ready; BAA available.

See Variants in your genomics workflow

We work with genomics labs, tumor boards, and life sciences R&D teams. Let's talk about your variant interpretation problem.