Fig. 5

ROC and DCA plots for the four multivariate predictive models for ECE+(blue, orange, green, red lines) and the univariate model derived from mECE (purple line) in participants with PCa. Panels (a), ROC and (b), DCA are for the discovery data set and panels (c) and (d) are for the validation data set, respectively. The DCA plots also include lines for the net benefit when all participants receive non-nerve-sparing surgery (NNSS) and when no participants receive NNSS (i.e. when all participants receive nerve-sparing surgery-NSS). The net benefit is equal to or higher than both lines for all models. The x-axis of the DCA plots is the threshold of the risk predicted by the model at which NNSS would be indicated. A vital aspect of the DCA concept is that this threshold is directly related to the ratio of the cost associated with false negative and false positive predictions– low values of the threshold correspond to the use case where failing to give NNSS (with curative intent) is more costly than the complications that may arise from using NNSS