Files
rarelens/README.md
T
Kemal Yaylali 07a01715fd feat: redesign around phenotype-driven triage, not variant filtering
A table with filters made the user do the work. Rare disease triage is a different task:
which few variants could explain *this* patient's phenotype, and why. The app now answers
that, and lets a reviewer act on the answer.

Domain
- a case is a proband: a VCF plus the HPO terms observed in the patient (samples -> cases)
- HPO's gene-to-phenotype annotations are loaded as reference data (scripts/load-hpo.py)
- each candidate can be shortlisted or dismissed with a reason and a note

Ranking (app/services/triage.py, 21 tests)
- weighted sum of phenotype match, rarity, consequence severity and the model's score,
  with every component shown next to the candidate
- rarity and consequence filter; phenotype only ranks, because a real diagnosis can sit in
  a gene nobody has annotated yet and filtering on it would hide exactly that case
- ClinVar is deliberately not an input: it appears beside the result as independent
  confirmation, so nothing ranks highly merely because ClinVar already said pathogenic

UI
- the funnel is the headline: variants called -> rare -> coding candidates -> phenotype-matched
- ranked candidates with evidence chips, not a grid of everything; filters are demoted
- a variant panel showing the score breakdown, the matched HPO terms, the raw VEP record and
  links out to Ensembl/gnomAD/ClinVar, with the decision controls
- a printable case report: phenotype, funnel, shortlisted variants with reasons, provenance

API: /cases with phenotypes, /cases/{id}/candidates (funnel + ranked + weights),
/variants/{id}, /variants/{id}/decision, /cases/{id}/report, /phenotypes for the picker.
Scoring moved under the case and now answers 503 with the reason when no model registry is
reachable, instead of a 500.

Verified end to end on a simulated proband (scripts/make-demo-case.sh: real GIAB HG002
background + one real ClinVar 2-star pathogenic NF2 variant). 13 variants called -> 1 coding
candidate, and the planted variant ranks first at 0.80 on phenotype 1.00, rarity 1.00 and
consequence 1.00, with ClinVar agreeing afterwards.

Tests: api 75, ml 18, loader 16, web 27; ruff, mypy, svelte-check, terraform validate, both
kustomize overlays and the Nextflow stub run all clean.
2026-09-12 08:30:44 +01:00

7.0 KiB

rarelens

A small, end-to-end variant interpretation platform for rare genetic disease research. A case is a proband: a VCF plus the patient's phenotype (HPO terms). A Nextflow workflow annotates the variants with Ensembl VEP, a model scores each one, and the app narrows thousands of variants to a handful of candidates ranked against that phenotype — each carrying the evidence for its rank, and each able to be shortlisted or dismissed with a reason that ends up in a case report.

This repository is a self-training lab. It exists so that one engineer can learn, in public, how a modern life-sciences platform is built end to end: full-stack application, scientific pipeline, ML serving, and cloud infrastructure, all in one monorepo. It is not a clinical tool and makes no diagnostic claims.

What is in the box

Layer Technology Directory
Pipeline Nextflow DSL2, bcftools, Ensembl VEP, Docker, Google Batch pipeline/
API FastAPI, Pydantic v2, SQLAlchemy 2.0 (async), Alembic api/
Database PostgreSQL 16 docker-compose.yml
Frontend SvelteKit, TypeScript web/
ML LightGBM pathogenicity scorer, MLflow registry ml/
Orchestration Argo Workflows + Argo Events (pipeline), Pub/Sub (events) infra/argo-workflows/
Platform Kubernetes (Kustomize), ArgoCD (GitOps) infra/k8s/, infra/argocd/
Cloud GCP: GKE Autopilot, Cloud SQL, GCS, Batch, Secret Manager, Artifact Registry infra/terraform/
CI/CD GitHub Actions, Workload Identity Federation .github/workflows/

Quick start (local)

make up          # postgres + api + web + mlflow via docker-compose
make migrate     # alembic upgrade head
make hpo         # HPO gene-to-phenotype annotations: what the ranking matches against
make demo-case   # a simulated proband: GIAB background + one ClinVar pathogenic variant
make test        # api, ml, loader and web tests (no Docker needed for the DB tests)

Then open http://localhost:5173, create a case pointing at data/proband-simulated.vcf.gz, give it the phenotype of the planted disease (for the default NF2 case: bilateral vestibular schwannoma, sensorineural hearing impairment, tinnitus, meningioma, cataract), and analyse it. The planted variant should come back ranked first.

The docker-compose API has no Nextflow, so "Run VEP annotation" marks the job failed with the command to run instead. With Nextflow and Docker on the host, a VEP cache in pipeline/cache/vep and a VCF under data/ (see data/README.md):

make annotate JOB=<job id from the UI> VCF=data/example.vcf.gz
make pipeline VCF=data/example.vcf.gz   # dry run: annotate without touching the database

No cache? VEP_DATABASE=true queries Ensembl's public database instead. It is slow per variant and returns fewer fields, but it needs no 25 GB download, which is enough to demonstrate the pipeline on a handful of variants:

VEP_DATABASE=true make pipeline VCF=pipeline/tests/data/tiny.vcf

To make the UI's "Run VEP annotation" button work, run the API on the host (where Nextflow and Docker are) rather than in docker-compose:

docker compose up -d db
cd api && DATABASE_URL=postgresql+asyncpg://rarelens:rarelens@localhost:5432/rarelens \
  PIPELINE_DATABASE_URL=postgresql+asyncpg://rarelens:[email protected]:5432/rarelens \
  LOCAL_DATA_ROOT=$PWD/.. VEP_DATABASE=true \
  uv run --extra dev uvicorn app.main:app --port 8000

PIPELINE_DATABASE_URL is what the loader container gets: inside it, the API's own localhost would be the container itself. LOCAL_DATA_ROOT is the directory a sample's vcf_uri must sit under.

To train and register a model (the API scores with models:/rarelens-pathogenicity@production):

cd ml && MLFLOW_TRACKING_URI=http://localhost:5000 \
  uv run python -m rarelens_ml.train --tsv ../pipeline/results/<sample>.vep.tsv --register

Local Kubernetes: make kind builds the images, loads them into a kind cluster and applies infra/k8s/overlays/local.

Deploying to GCP

Two tracks, same code. The serverless one is the default because it costs about £1/month idle; docs/cloud.md has the numbers.

Serverless (Cloud Run + Google Batch). The API and the UI scale to zero, and the Nextflow driver runs as a Cloud Run job only while a pipeline is running.

cd infra/terraform
terraform init -backend-config="bucket=<tfstate bucket>"
export TF_VAR_database_url='postgresql+asyncpg://user:pass@host/db?sslmode=require'  # e.g. Neon's free tier
terraform apply -var project=<project id>          # add -var deploy_cloud_sql=true to use Cloud SQL instead
cd ../.. && make serverless-deploy PROJECT=<project id> TAG=<commit sha>   # redeploy a new build

terraform output web_url is the URL to share; it serves the UI and proxies /api to the API, so there is one public address and no CORS. Upload the VEP cache to gs://<project>-rarelens-data/refs/vep before running a real annotation, and set -var model_uri=gs://<project>-rarelens-data/models/pathogenicity/1 to score without running an MLflow server. Set a billing budget first — the demo has no authentication.

Kubernetes (GKE + Argo + ArgoCD). Off by default; turn it on to demonstrate the GitOps path, then destroy it.

terraform apply -var project=<project id> -var deploy_kubernetes=true -var deploy_cloud_sql=true
make gcp-configure PROJECT=<project id>   # once; commit the result
make gcp-secrets PROJECT=<project id>

Then install Argo Workflows, Argo Events and ArgoCD, and kubectl apply -f infra/argocd/app.yaml. Every green CI run on main bumps image tags in the gcp overlay and ArgoCD deploys them. make serverless-destroy PROJECT=<project id> tears everything down.

Data

The demo runs on published, openly licensed human data: the NIST Genome in a Bottle HG002 benchmark genome as the sample, ClinVar for labels, gnomAD for allele frequencies. Sources, licences, citations and how the model should be evaluated honestly are in docs/data.md.

Architecture

See docs/architecture.md for the diagram and the reasoning behind each choice, and docs/cloud.md for why this deploys to Google Cloud rather than AWS.

Status

Work in progress. Milestones, in order:

  1. Skeleton, Postgres, FastAPI, Nextflow VEP annotation on a public VCF, CI green
  2. SvelteKit UI: sample list, variant table with filters, job status
  3. Kubernetes manifests, kind, Argo Workflows trigger
  4. Terraform for GCP, ArgoCD GitOps deploy
  5. Pathogenicity model, MLflow registry, prediction endpoint

Licence

AGPL-3.0. Test data are public (ClinVar, gnomAD subsets); no patient data are used or accepted.