Slice Testing - Considerations from Ordering to Reporting

Authoring Organizations

Publication Month/Year

December 14, 2023

Last Updated Month/Year

January 3, 2024

Document Type


Country of Publication


Document Objectives

As the number of genes associated with various germline disorders continues to grow, it is becoming more difficult for clinical laboratories to maintain separate assays for interrogating disease focused gene panels. One solution to this challenge is termed slice testing, where capture backbone is utilized to analyze data specific to a set of genes, and for this paper, we will focus on exome. A key advantage to this strategy is greater flexibility by adding genes as they become associated with disease or the ability to accommodate specific provider requests. Here, we provide expert consensus recommendations and results from an Association for Molecular Pathology-sponsored survey of clinical laboratories performing exome sequencing to compare a slice testing approach with traditional static gene panels and comprehensive exome analysis. We explore specific considerations for slices, including gene selection, analytic performance, coverage, quality, and interpretation. Our goal is to provide comprehensive guidance for clinical laboratories interested in designing and utilizing slice tests as a diagnostic.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Laboratory services

Intended Users

Genetics, laboratory technician, nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Management


slice testing, exome sequencing, genomic sequencing

Source Citation

Jeffrey A. SoRelle, Birgit H. Funke, Celeste C. Eno, Jianling Ji, Avni Santani, Pinar Bayrak-Toydemir, Megan Wachsmann, Karen E. Wain, Rong Mao, Slice Testing - Considerations from Ordering to Reporting: A Joint Report of the Association for Molecular Pathology, College of American Pathologists, and National Society of Genetic Counselors, The Journal of Molecular Diagnostics, 2023, ISSN 1525-1578, https://doi.org/10.1016/j.jmoldx.2023.11.008

Supplemental Methodology Resources

Data Supplement, Data Supplement