Internal validation of the well-trained ANN models and the strategy of shifting diagnosis threshold. a The relation between specificity and sensitivity with varying \(\Delta\) from \(-20\) to \(25\%\). b \(\Delta\) was the variation of decision threshold and the minorities or positives were predicted if \(o_1 > 0.5-\Delta\). c–e showed the confusion matrix when \(\Delta\) was 0, \(15\%\) and \(25\%\). Category 1 showed SLE patients with fetal-loss outcomes and Category 2 were ones with live-birth outcomes. f visualization of the three metrics in different \(\Delta\).