Interpretable multimodal artificial intelligence model for predicting advanced neoplasia in pancreatic cystic lesions

Figure 4 Decision curve analysis comparing net clinical benefit of the integrated model and guideline-based strategies. Decision curve analysis illustrating net benefit across threshold probabilities between 5% and 50% for recommending surgical resection. The integrated multimodal model demonstrates superior net benefit across clinically relevant thresholds compared with guideline-based criteria. Horizontal lines represent “treat all” and “treat none” strategies. Because all patients in the cohort underwent resection, net benefit estimates reflect counterfactual model-based scenarios.