Table 3:

Performance measures using cohort-derived optimized Youden thresholds (Figure 1, dashed lines). Refer to Supplemental Table A.1 for complete size-based breakdown.

MPM	Nodule Size	Optimized threshold performance and recommendation for treatment/ nodule evaluation
MC	All	< 21% Low Risk	≥ 21% High Risk
		19M: 180B	61M: 57B
		24% malignant wait	24% benign immediate work-up
	≥ 8mm to < 15mm	8M: 67B	19M: 25B
		30% malignant wait	30% benign immediate work-up
	≥ 15mm	2M: 2B	40M: 28B
		5% malignant wait	93% benign immediate work-up
VA	All	< 50% Low Risk	≥ 50% High Risk
		34M: 197B	46M: 40B
		43% malignant wait	17% benign immediate work-up
	≥ 8mm to < 15mm	16M: 75B	11M: 17B
		59% malignant wait	18% benign immediate work-up
	≥ 15mm	7M: 8B	35M: 22B
		17% malignant wait	73% benign immediate work-up
BU	All	< 10% Low Risk	≥ 10% High Risk
		19M: 178B	61M: 59B
		24% malignant wait	25% benign extra procedures
	≥ 8mm to < 15mm	9M: 61B	18M: 31B
		33% malignant wait	34% benign immediate work-up
	≥ 15mm	0M: 1B	42M: 29B
		0% malignant wait	97% benign immediate work-up
PU	All	< 70% Low Risk	≥ 70% High Risk
		18M: 154B	62M: 83B
		22% malignant wait	35% benign immediate work-up
	≥ 8mm to < 15	9M: 56B	18M: 36B
		33% malignant wait	39% benign immediate work-up
	≥ 15mm	6M: 18B	36M: 12B
		14% malignant wait	39% benign immediate work-up

Definition of abbreviations: MPM – mathematical prediction model; MC – Mayo Clinic; VA – Veteran’s Affairs; BU – Brock University; PU – Peking University; M – malignant; B - benign