Fig. 1. Overview of the study design.

a, The C-Lung-RADS training and internal testing datasets were obtained from the MCC at the health management center in West China Hospital of Sichuan University, and the independent testing data were obtained from the MSC at multicenter communities in Western China. The subset included in the study was determined based on the inclusion and exclusion criteria, as shown in Extended Data Fig. 1. b, C-Lung-RADS pipeline architecture: phase 1 initially classified the risk of nodules by evaluating nodule size and density through decision tree models, phase 2 distinguished suspicious malignant nodules through CT images and phase 2+ targeted suspicious malignant nodules through multimodal data fusion. c, Management of nodules with different risk levels was performed accordingly.