Letter re: Multimodal AI-based risk stratification for distant metastasis in nasopharyngeal carcinoma

We read with interest the study by Zhou et al. in ESMO Open1 on a multimodal deep learning-based [graph for nasopharyngeal carcinoma (GNPC)] digital score for predicting distant metastasis risk in nasopharyngeal carcinoma (NPC) incorporating signals from both hematoxylin–eosin-stained whole-slide images and clinical data. Despite the robust predictive performance of GNPC score, the rigor in the following aspects merits further discussion.