Fig. 4

Decision curve analyses for the original model with DOATS, the original model with DOAT, and the DOATS and DOAT scores in the original cohort. The graph illustrates the net benefit relative to no treatment in any patient (‘Treat none’) using different treatment approaches. The gray line represents the scenario where no patients are treated, resulting in a net benefit of zero (no true-positive and no false-positive classifications). The black line represents the scenario where all patients are treated. The colored lines correspond to different treatment thresholds based on the predictions of the DOATS-based original model (blue line), DOAT-based original model (green line), DOATS score (red line), and DOAT score (orange line) for the risk of deterioration. This graph demonstrates the expected net benefit when treatment decisions are made based on these different approaches. The analysis confirms the clinical practicability and utility of both scores, as well as the original models