Methods for detecting nucleic acid variants

1. A method for detecting a short genetic variant associated with a disease in a test sample, comprising:

selecting a target short genetic variant associated with a disease, such that a target sequencing data set associated with a target sequence comprising the target short genetic variant differs from a reference sequencing data set associated with a reference sequence at four or more consecutive flow positions when the target sequencing data set and the reference sequencing data set are obtained by sequencing the target sequence and the reference sequence, respectively, using non-terminating nucleotides provided in separate flow positions according to a flow-cycle order;

obtaining one or more test sequencing data sets, each test sequencing data set associated with a test nucleic acid sequence, each test nucleic acid sequence at least partially overlapping a locus associated with the target short genetic variant and derived from the test sample, wherein the one or more test sequencing data sets were determined by sequencing the test sample using non-terminating nucleotides provided in separate flow positions according to the flow-cycle order;

determining, for each test nucleic acid sequence, a respective match score indicative of a likelihood that the test sequencing data set matches the target sequencing data set, or a respective match score indicative of a likelihood that the test sequencing data set matches the reference sequencing data set; and

calling, using the one or more respective match scores, the presence or absence of the target short genetic variant in the test sample;

wherein the target short genetic variant is selected prior to calling the presence or absence of the target short genetic variant in the test sample.

2. The method of claim 1 , wherein the obtaining comprises sequencing test nucleic acid molecules derived from the test sample using non-terminating nucleotides provided in separate flow positions according to the flow-cycle order, and wherein each test nucleic acid molecule is associated with a respective test sequencing data set.

3. The method of claim 1 , further comprising generating a personalized biomarker panel for a subject associated with the test sample, the personalized biomarker panel comprising the target short genetic variant.

4. The method of claim 1 , further comprising selecting the flow-cycle order.

5. The method of claim 1 , wherein the target sequencing data set and the reference sequencing data set are obtained by sequencing the target sequence and the reference sequence in silico.

6. The method of claim 2 , wherein each of the one or more test sequencing data sets comprises flow signals at the separate flow positions, and the flow signals comprise a base count indicative of a number of bases of the respective test nucleic acid molecule sequenced at each flow position.

7. The method of claim 6 , wherein the flow signals comprise a statistical parameter indicative of a likelihood for at least one base count at each flow position, wherein the base count is indicative of a number of bases of the respective test nucleic acid molecule sequenced at the flow position.

8. The method of claim 6 , wherein the flow signals comprise a statistical parameter indicative of a likelihood for a plurality of base counts at each flow position, wherein each base count is indicative of a number of bases of the respective test nucleic acid molecule sequenced at the flow position.

9. The method of claim 8 , wherein the determining comprises:

selecting the statistical parameter at each flow position in the test sequencing data set that corresponds with a base count of the target sequence at that flow position, and determining the respective match score indicative of the likelihood that the test sequencing data set matches the target sequencing data set; or

selecting the statistical parameter at each flow position in the test sequencing data set that corresponds with a base count of the reference sequence at that flow position, and determining the respective match score indicative of the likelihood that the test sequencing data set matches the reference sequencing data set.

10. The method of claim 9 , wherein the respective match score determined in the determining is a combined value of the selected statistical parameters across the flow positions in the test sequencing data set.

11. The method of claim 1 , wherein the determining comprises determining the respective match score indicative of the likelihood that the test sequencing data set matches the target sequencing data set.

12. The method of claim 1 , wherein the determining comprises determining the respective match score indicative of the likelihood that the test sequencing data set matches the reference sequencing data set.

13. The method of claim 1 , wherein the one or more test sequencing data sets comprises a plurality of test sequencing data sets.

14. The method of claim 13 , wherein the presence or absence of the target short genetic variant is separately called for each of the one or more test sequencing data sets.

15. The method of claim 13 , wherein at least a portion of the plurality of test sequencing data sets are associated with different test nucleic acid molecules have different sequencing start positions.

16. The method of claim 1 , wherein the flow-cycle order comprises 4 separate flows repeated in the same order.

17. The method of claim 1 , wherein the flow-cycle order comprises 5 or more separate flows.

18. A method for detecting a short genetic variant associated with a disease in a test sample, comprising:

obtaining one or more first test sequencing data sets, each first test sequencing data set associated with a different test nucleic acid molecule derived from the test sample, wherein the first test sequencing data sets were determined by sequencing one or more test nucleic acid molecules using non-terminating nucleotides provided in separate flow positions according to a first flow-cycle order, and wherein the one or more first test sequencing data sets comprise flow signals at the separate flow positions;

obtaining one or more second test sequencing data sets, each second test sequencing data set associated with a same respective test nucleic acid molecule as a corresponding first test sequencing data set, wherein the second test sequencing data sets were determined by re-sequencing the one or more test nucleic acid molecules using non-terminating nucleotides provided in separate flow positions according to a second flow-cycle order, wherein the first flow-cycle order and the second flow-cycle order are different, and wherein the one or more second test sequencing data sets comprises flow signals at the separate flow positions;

determining, for each first sequencing data set and corresponding second sequencing data set, a respective match score to one or more candidate sequences, wherein the respective match score is indicative of a likelihood that the first test sequencing data set, the second test sequencing data set, or both, matches a candidate sequence from the one or more candidate sequences; and

calling, using the determined match scores, the presence or absence of the short genetic variant in the test sample.

19. A method of sequencing a nucleic acid molecule, comprising:

hybridizing the nucleic acid molecule to a primer to form a hybridized template;

extending the primer using labeled, non-terminating nucleotides provided in separate flow positions according to a repeated flow-cycle order comprising five or more separate nucleotide flows; and

detecting a signal from an incorporated labeled nucleotide or an absence of a signal as the primer is extended by the nucleotide flows.