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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Susan M Belloa, Cynthia L Smitha, Lynn M Schrimlb</article-title>
      </title-group>
      <contrib-group>
        <aff id="aff0">
          <label>0</label>
          <institution>Disease</institution>
          ,
          <addr-line>Ontology, Integration</addr-line>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>University of Maryland School of Medicine, Institute for Genome Sciences</institution>
          ,
          <addr-line>Baltimore, MD</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Integrating information from multiple disease resources into the Disease Ontology (DO) requires understanding how different resources represent disease related information. Here we present how the DO team integrates OMIM into the DO including approaches prioritizing entries and developing guidelines for consistent integration of different types of disease related entries in OMIM.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>Introduction</title>
      <p>As our understanding of human disease changes and evolves over
time it is necessary to review and revise disease entity
relationships between different disease resources. In the Disease
Ontology (DO, http://www.disease-ontology.org (1)) terms from
many different disease resources are integrated as database
crossreferences (dbxrefs) to DO terms. Given the importance of the of
the Online Mendelian Inheritance in Man (OMIM, omim.org (2))
as the gold standard reference for human disease and the relation
of these disease terms to human genes, integrating and
maintaining the OMIM cross-references in the DO is a high
priority set of tasks.</p>
    </sec>
    <sec id="sec-2">
      <title>Methods</title>
      <p>The tasks involved in integrating OMIM into the DO include:
refining and maintaining the relations between OMIM phenotypic
series and DO terms; identifying cases where changes in OMIM
result in a change in the disease attached to a specific OMIM ID;
removing obsolete OMIM IDs from the DO; and adding new
OMIM IDs to the DO as OMIM adds additional phenotypes. The
DO GitHub site currently has 52 reported issues that relate to
OMIM disease terms, marked with the label ‘OMIM’. These
include both ongoing curation tasks and requests for the
incorporation of specific OMIM terms from external users. A
number of the external user requests for additions or refinement
of OMIM phenotypic series representation have been combined
to identify those OMIM terms that were requested by multiple
groups.</p>
    </sec>
    <sec id="sec-3">
      <title>Results</title>
      <p>In addition to integrating OMIM entries representing disease
phenotypes, our team is developing a set of guidelines for
determining whether to incorporate all of the members of the
OMIM phenotypic series (representing the genetic heterogeneity
of similar disease phenotypes across the genome and including
susceptibility and modifier loci). For example, the OMIM
phenotypic series ‘Parkinson Disease’ (PS168600) has 31 entries
representing 24 unique OMIM records. Fifteen of these IDs have
been incorporated into the DO as cross references to DO terms.
For instance, the DO term ‘autosomal recessive juvenile
Parkinson's disease 2’ (DOID:0060368) has a cross-reference to
the OMIM term ‘PARKINSON DISEASE 2, AUTOSOMAL
RECESSIVE JUVENILE’ (OMIM:600116). Here the OMIM
term represents a subtype of Parkinson’s disease defined by
mutation in the PARK2 gene. A further 4 OMIM records
(OMIM:607688, OMIM:610297, OMIM:613643,
OMIM:614251) are related to the DO term Parkinson's disease
(DOID:14330) not as cross-references but instead using the
relation ‘contributes to condition’ (RO:0003304). These OMIM
records do not represent subtypes of Parkinson’s disease but are
instead representing susceptibility or risk loci. The remaining 5
OMIM records are in the review process. Some of these
(OMIM:613164, OMIM:300557) have titles in OMIM that
resemble those of the disease subtypes, however, review of the
OMIM text and associated references suggests that these may be
susceptibility or modifier loci. Consultation with OMIM
regarding these subtypes identified that insufficient evidence was
available to decide how to classify these entries at the current
time. Thus it was decided to not incorporate these in the DO until
further knowledge is presented.</p>
    </sec>
    <sec id="sec-4">
      <title>Conclusions</title>
      <p>This work has made clear that reliable and accurate incorporation
of entities from disease resources into the DO requires both a
thorough understanding of disease concepts, coordination and
codevelopment of guidelines and insight into the nuances of
representation of these concepts by various resources. Only
through careful review and consultation with these resources can
we provide an integrated view of disease in the DO.</p>
      <p>Copyright © 2019 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
National Institutes of Health–National Human Genome
Research Institute (NHGRI) [U41 HG008735-01A1]</p>
    </sec>
    <sec id="sec-5">
      <title>Address for correspondence</title>
    </sec>
    <sec id="sec-6">
      <title>References</title>
    </sec>
  </body>
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</article>