PROJECT SUMMARY This application proposes to supplement software development in our parent grant R01HG012286, entitled “Calypso: a web software system supporting team-based, longitudinal genomic diagnostic care”. We are developing Calypso to meet diagnostic analysis needs in clinical settings where a large fraction of patients remain non-diagnostic for an extended period of time, i.e. undiagnosed disease clinics, neonatal intensive care units, and pediatric subspecialty clinics. Our cloud-based platform will provide the capacity for long-term storage and periodic automated reanalysis of the patient’s genomic data; a suite of intuitive IOBIO webtools will enable diagnostic analysis; and a case-focused communication and collaboration interface will coordinate diagnostic teamwork. However, even the best-orchestrated diagnostic variant analysis process cannot succeed if the disease-causing variant remains undetected. Whereas established computational pipelines exist for highly accurate and sensitive detection of inherited variations, current tools still underperform for detecting de novo disease- causing mutations, especially structural variant events. To address this bottleneck, we have developed a kmer-based mutation detection software tool, RUFUS, and demonstrated its ability to substantially improve the detection of causative DNMs in a variety of diseases. In accordance with the aims of funding opportunity NOT-OD-22-068 “Enhancing Software Tools for Open Science and the Cloud”, here we propose to enhance the impact of the currently research-grade RUFUS tool by improving its implementation and cloud-readiness to accelerate its adoption by the broader genomic medicine community. First, we will re-engineer the core RUFUS code base to produce a robust, production-ready, and easily maintainable software package, without altering its already effective algorithmic behavior. We will replace RUFUS’s currently ad hoc input/output handling with the de facto community standard HTSlib library; restructure logging to produce informative runtime messages; and implement automated code testing (both unit and integration testing) to ease future development. Second, we will enable cloud-native adoption of the RUFUS package which was originally designed to operate in a Linux environment. We will improve scalability by adapting RUFUS for distributed computing, and thereby achieving a higher level of parallelization and execution speed than possible with the current, multi-threaded, implementation; and institute containerization to enable RUFUS’s incorporation into cloud-native runtime environments and workflow language-base pipelines. Finally, third, we will enhance user and developer community engagement, by adopting standard versioning practices to provide the prerequisite software provenance for incorporation into clinical diagnostic pipelines; enrolling our software into standard container registry services so users can easily find our tool; and expanding currently skeletal tool documentation to ease user adoption. Importantly, we will provide example nextflow workflows for RUFUS’s common use cases, together with representative datasets for each use case.

NARRATIVE We are developing software to support team-based, long-term genomic analysis in challenging settings such as undiagnosed disease clinics and rapid genome sequencing programs to rapidly diagnose critically ill newborns in neonatal intensive care units. We will test the utility of our software for assisting diagnostic analysis in a team- based setting within individual clinics and for facilitating research consortium-level collaborative diagnostics within NHGRI’s Undiagnosed Diseases Network.