Abstract Survival analysis has been developed and applied in the number of areas including manufacturing, finance, economics and healthcare. In healthcare domain, usually clinical data are high-dimensional, sparse and complex and sometimes there exists few amount of time-to-event (labeled) instances. Therefore building an accurate survival model from electronic health records is challenging. With this motivation, we address this issue and provide a new survival analysis framework using deep learning and active learning with a novel sampling strategy. First, our approach provides better representation with lower dimensions from clinical features using labeled (time-to-event) and unlabeled (censored) instances and then actively trains the survival model by labeling the censored data using an oracle. As a clinical assistive tool, we introduce a simple effective treatment recommendation approach based on our survival model. In the experimental study, we apply our approach on SEER-Medicare data related to prostate cancer among African–Americans and white patients. The results indicate that our approach outperforms significantly than baseline models.
@cite_4 provided the first ever active learning framework for survival analysis. They developed this approach just for regularized Cox regression survival models. Authors proposed a novel sampling strategy based on discriminative gradient for selecting the best candidate from the unlabeled pool set. Finally, they evaluated their model performance using public EHRs datasets and compared with some state of the art survival regression methods.
@cite_4
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Time-to-event outcomes based data can be modelled using survival regression methods which can predict these outcomes in different censored data applications in diverse fields such as engineering, economics and healthcare. Predictive models are built by inferring from the censored variable in time-to-event data, which differentiates them from other regression methods. Censoring is represented as a binary indicator variable and machine learning methods have been tuned to account for the censored attribute. Active learning from censored data using survival regression methods can make the model query a domain expert for the time-to-event label of the sampled instances. This offers higher advantages in the healthcare domain where a domain expert can interactively refine the model with his feedback. With this motivation, we address this problem by providing an active learning based survival model which uses a novel model discriminative gradient based sampling scheme. We evaluate this framework on electronic health records (EHR), publicly available survival and synthetic censored datasets of varying diversity. Experimental evaluation against state of the art survival regression methods indicates the higher discriminative ability of the proposed approach. We also present the sampling results for the proposed approach in an active learning setting which indicate better learning rates in comparison to other sampling strategies. Praise for the Third Edition. . . an easy-to read introduction to survival analysis which covers the major concepts and techniques of the subject. Statistics in Medical ResearchUpdated and expanded to reflect the latest developments, Statistical Methods for Survival Data Analysis, Fourth Edition continues to deliver a comprehensive introduction to the most commonly-used methods for analyzing survival data. Authored by a uniquely well-qualified author team, the Fourth Edition is a critically acclaimed guide to statistical methods with applications in clinical trials, epidemiology, areas of business, and the social sciences. The book features many real-world examples to illustrate applications within these various fields, although special consideration is given to the study of survival data in biomedical sciences.Emphasizing the latest research and providing the most up-to-date information regarding software applications in the field, Statistical Methods for Survival Data Analysis, Fourth Edition also includes:Marginal and random effect models for analyzing correlated censored or uncensored dataMultiple types of two-sample and K-sample comparison analysisUpdated treatment of parametric methods for regression model fitting with a new focus on accelerated failure time modelsExpanded coverage of the Cox proportional hazards modelExercises at the end of each chapter to deepen knowledge of the presented materialStatistical Methods for Survival Data Analysis is an ideal text for upper-undergraduate and graduate-level courses on survival data analysis. The book is also an excellent resource for biomedical investigators, statisticians, and epidemiologists, as well as researchers in every field in which the analysis of survival data plays a role. Previous research has shown that neural networks can model survival data in situations in which some patients' death times are unknown, e.g. right-censored. However, neural networks have rarely been shown to outperform their linear counterparts such as the Cox proportional hazards model. In this paper, we run simulated experiments and use real survival data to build upon the risk-regression architecture proposed by Faraggi and Simon. We demonstrate that our model, DeepSurv, not only works as well as other survival models but actually outperforms in predictive ability on survival data with linear and nonlinear risk functions. We then show that the neural network can also serve as a recommender system by including a categorical variable representing a treatment group. This can be used to provide personalized treatment recommendations based on an individual's calculated risk. We provide an open source Python module that implements these methods in order to advance research on deep learning and survival analysis. Medical practitioners use survival models to explore and understand the relationships between patients’ covariates (e.g. clinical and genetic features) and the effectiveness of various treatment options. Standard survival models like the linear Cox proportional hazards model require extensive feature engineering or prior medical knowledge to model treatment interaction at an individual level. While nonlinear survival methods, such as neural networks and survival forests, can inherently model these high-level interaction terms, they have yet to be shown as effective treatment recommender systems. We introduce DeepSurv, a Cox proportional hazards deep neural network and state-of-the-art survival method for modeling interactions between a patient’s covariates and treatment effectiveness in order to provide personalized treatment recommendations. We perform a number of experiments training DeepSurv on simulated and real survival data. We demonstrate that DeepSurv performs as well as or better than other state-of-the-art survival models and validate that DeepSurv successfully models increasingly complex relationships between a patient’s covariates and their risk of failure. We then show how DeepSurv models the relationship between a patient’s features and effectiveness of different treatment options to show how DeepSurv can be used to provide individual treatment recommendations. Finally, we train DeepSurv on real clinical studies to demonstrate how it’s personalized treatment recommendations would increase the survival time of a set of patients. The predictive and modeling capabilities of DeepSurv will enable medical researchers to use deep neural networks as a tool in their exploration, understanding, and prediction of the effects of a patient’s characteristics on their risk of failure.