Design of the MedalCeremony pipeline for automated germline variant classification. Truncating variants in loss-of-function genes (e.g., tumor suppressors) and those matching highly curated databases receive gold medals. Truncations in non-loss-of-function genes, in-frame indels, variants predicted to be damaging, and matches to additional databases receive silver medals. Otherwise, variants predicted to be tolerated by damage-prediction algorithms receive bronze medals. Imperfect database matches receive a lower-grade medal than exact matches. Variants not meeting any of the prior criteria are labeled “unknown.”