One limitation to our analysis of the HCI variant dictionary in relation to ClinVar is that we do not account for reporting gaps. For example, consider the gap in laboratory updates to ClinVar records. Updates occur at different frequencies (quarterly, annually, etc.) depending on the laboratory. A laboratory may have sent an updated interpretation to HCI that has not yet been propagated to ClinVar and this may have caused an interpretation conflict. Additionally, there are possible gaps from HCI between when a variant reclassification notification is received and when the variant review team can meet to discuss the update. In summary, these cross-sectional snapshots may be reflecting discrepancies that are already known and being processed.