Then, the decision curve analysis (DCA) for the diagnostic genes (ARHGDIB, ALDH1A1, TREM1, TACR3 and PI3) and that for the model with diagnostic genes integrated was presented in Fig. 6C. The DCA showed that if the threshold probability of a patients or doctor is > 10%, using the individual genes or diagnostic model to predict the occurrence of ALI adds more benefit than either diagnosis-all-patients scheme or the diagnosis-none scheme. This evidence concerns the gene PI3 and acute respiratory distress syndrome.