Figure 4: (a) Decision curve analysis in the diagnostic biopsy (DB) patient cohort of the net benefit of five different treatment decision strategies (treat all, treat none, treat based on the CAPRA score, treat based on the CAPRA and PDE4D7 score, treat based on the CAPRA and PDE4D5/7/9 score) for men at risk of disease recurrence within 5 years after surgery. In total 45 of the 151 investigated patients failed the initial primary treatment of surgery by PSA recurrence (29.8%) within 5 years after intervention. Treatment strategies were tested for their net benefit across indicated threshold probabilities (0.05 step size) to trigger prostate surgery based on the probability of future disease recurrence. The CAPRA scores, the CAPRA and PDE4D7 scores, and the CAPRA and PDE4D5/7/9 scores were converted into 5-year BCR probabilities with logistic regression on the BP cohort (n=151 men with completed 5-year follow-up) before estimating net benefit. (b) Net reduction analyses demonstrating in how many patients a resection can be avoided based on the predicted risk of BCR derived from the CAPRA score and the CAPRA and PDE4D7 and CAPRA and PDE4D5/7/9 scores, respectively.