Routine laboratory model for identifying significant fibrosis in chronic hepatitis B

Figure 5 Decision curve analysis of the machine-learning model in the development and external validation cohorts. Decision curve analysis comparing the ensemble model with aspartate aminotransferase to platelet ratio index, fibrosis-4, and the “treat-all” and “treat-none” strategies in the development cohort and external validation cohort. Across clinically relevant threshold probabilities, the ensemble model showed comparable or higher net benefit, supporting its potential clinical utility for identifying patients with significant fibrosis. The shaded region indicates the prespecified interpretive threshold range (0.20-0.50) used for primary interpretation of net benefit. FAHZU: First Affiliated Hospital of Zhejiang University; APRI: Aspartate aminotransferase to platelet ratio index; FIB-4: Fibrosis-4.