AnnotateMissense: a genome-wide annotation and benchmarking framework for missense pathogenicity prediction

Missense variant interpretation remains challenging because pathogenicity depends on heterogeneous evidence from population frequency, evolutionary conservation, transcript context, amino acid substitution severity, prior pathogenicity predictors and protein-language-model-derived features. We present AnnotateMissense, a scalable annotation, benchmarking and genome-wide prediction framework for missense variant interpretation. AnnotateMissense integrates hg38 missense variants derived from dbNSFP v5.1 with ANNOVAR annotations, dbNSFP transcript/protein descriptors, AlphaMissense scores, ESM-derived features, conservation metrics, population-frequency variables, established pathogenicity predictors and engineered amino acid/codon-context features. Using 132,714 ClinVar-labelled missense variants, we benchmarked machine-learning and deep-learning models under controlled feature configurations. The full 303-feature benchmark set achieved the strongest performance with XGBoost, reaching mean MCC = 0.9411 and ROC-AUC = 0.9950 across stratified five-fold cross-validation. Restricted naive and location-oriented feature sets achieved lower best MCC values of 0.4989 and 0.5113, respectively. Circularity-controlled ablations showed that removing prior-predictor, population-frequency and clinically overlapping evidence reduced performance, whereas excluding AlphaMissense and ESM-derived features alone had minimal effect. Temporal ClinVar validation on newly observed pathogenic/benign variants achieved MCC = 0.7613, accuracy = 0.8798 and F1-score = 0.8750. The final model was applied to 90,643,830 hg38 missense variants to generate AnnotateMissense pathogenicity scores and binary prediction labels. Code and outputs are available at https://github.com/MuhammadMuneeb007/CAGI7_Annotate_All_Missense and https://doi.org/10.5281/zenodo.19981867.