The Modern Challenge
Next-Generation Sequencing (NGS) provides a flood of genomic data. However, a "translation gap" exists, making it challenging for clinicians to interpret this data and apply it to patient care. This workflow bridges that gap by connecting data generation to clinical action.
The Solution: A Two-Part Process
1. The "Question"
Genomic Diagnostic Report
2. The "Answer"
Curated Knowledgebase
The CIViC Knowledgebase (The "Library")
When the report isn't straightforward, the clinician turns to an open-access knowledgebase like CIViC. It provides a transparent, evidence-based structure for interpreting variants.
Evidence Item (EID)
The "brick." A single clinical statement from a single, citable source (e.g., one clinical trial).
Assertion (AID)
The "wall." A consensus summary synthesized from multiple EIDs.
CIViC Evidence Hierarchy
CIViC's most critical feature is its hierarchy, allowing clinicians to instantly filter by evidence quality. Level A (Validated) is highly actionable, while Level E (Inferential) is not used for clinical decisions.
The Clinical Workflow in Practice
A case study: An NSCLC patient's report shows a MET Exon 14 Skipping Mutation. It's not a common CDx, so the oncologist queries CIViC.
Search
Search "MET" in CIViC and find the Molecular Profile.
Filter & Sort
Filter by "Predictive" evidence and sort by "Level A".
Appraise EIDs
Review Level A/B EIDs citing pivotal trials (GEOMETRY, VISION).
Synthesize AID
Find a "Tier I, Level A" Assertion, confirming high-level validation.
Result: On-Label, Standard-of-Care Option Identified
Final Treatment Formulation
The CIViC finding is powerful, but it's not the final step. The oncologist must synthesize all information into a holistic, patient-centered "safety case" for the final decision.
1. Genomic Data
Patient's tumor has a MET Exon 14 Skipping mutation.
2. Curated Evidence (CIViC)
A Tier I, Level A Assertion confirms it's highly actionable.
3. Clinical Guidelines (NCCN)
"Gold standard" check. NCCN lists MET inhibitors as "Category 1" for this variant.
4. Patient-Specific Factors
Age, comorbidities, performance status, and drug toxicity profiles.
Final Treatment Plan
An evidence-based, guideline-concordant, and patient-centered recommendation.