Survival analysis in the presence of multiple possible adverse events, i.e., competing risks, is a pervasive problem in many industries (healthcare, finance, etc.). Since only one event is typically observed, the incidence of an event of interest is often obscured by other related competing events. This nonidentifiability, or inability to estimate true cause-specific survival curves from empirical data, further complicates competing risk survival analysis. We introduce Siamese Survival Prognosis Network (SSPN), a novel deep learning architecture for estimating personalized risk scores in the presence of competing risks. SSPN circumvents the nonidentifiability problem by avoiding the estimation of cause-specific survival curves and instead determines pairwise concordant time-dependent risks, where longer event times are assigned lower risks. Furthermore, SSPN is able to directly optimize an approximation to the C-discrimination index, rather than relying on well-known metrics which are unable to capture the unique requirements of survival analysis with competing risks.
Previous work on classical survival analysis has demonstrated the advantages of deep learning over statistical methods @cite_26 @cite_1 @cite_8 . Cox proportional hazards model @cite_15 is the baseline statistical model for survival analysis, but is limited since the dependent risk function is the product of a linear covariate function and a time dependent function, which is insufficient for modeling complex non-linear medical data. @cite_1 replaced the linear covariate function with a feed-forward neural network as input for the Cox PH model and demonstrated improved performance. The current literature addresses competing risks based on statistical methods (the Fine Gray model @cite_21 ), classical machine learning (Random Survival Forest @cite_7 @cite_22 ), multi-task learning @cite_4 ) etc., with limited success. These existing competing risk models are challenged by computational scalability issues for datasets with many patients and multiple covariates. To address this challenge, we propose a deep learning architecture for survival analysis with competing risks to optimize the time-dependent discrimination index. This is not trivial and will be elaborated in the next section.
@cite_26 @cite_4 @cite_22 @cite_7 @cite_8 @cite_21 @cite_1 @cite_15
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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. 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. An accurate model of patient-specific kidney graft survival distributions can help to improve shared-decision making in the treatment and care of patients. In this paper, we propose a deep learning method that directly models the survival function instead of estimating the hazard function to predict survival times for graft patients based on the principle of multi-task learning. By learning to jointly predict the time of the event, and its rank in the cox partial log likelihood framework, our deep learning approach outperforms, in terms of survival time prediction quality and concordance index, other common methods for survival analysis, including the Cox Proportional Hazards model and a network trained on the cox partial log-likelihood. Abstract Visual tracking algorithms based on structured output support vector machine (SOSVM) have demonstrated excellent performance. However, sampling methods and optimization strategies of SOSVM undesirably increase the computational overloads, which hinder real-time application of these algorithms. Moreover, due to the lack of high-dimensional features and dense training samples, SOSVM-based algorithms are unstable to deal with various challenging scenarios, such as occlusions and scale variations. Recently, visual tracking algorithms based on discriminative correlation filters (DCF), especially the combination of DCF and features from deep convolutional neural networks (CNN), have been successfully applied to visual tracking, and attains surprisingly good performance on recent benchmarks. The success is mainly attributed to two aspects: the circular correlation properties of DCF and the powerful representation capabilities of CNN features. Nevertheless, compared with SOSVM, DCF-based algorithms are restricted to simple ridge regression which has a weaker discriminative ability. In this paper, a novel circular and structural operator tracker (CSOT) is proposed for high performance visual tracking, it not only possesses the powerful discriminative capability of SOSVM but also efficiently inherits the superior computational efficiency of DCF. Based on the proposed circular and structural operators, a set of primal confidence score maps can be obtained by circular correlating feature maps with their corresponding structural correlation filters. Furthermore, an implicit interpolation is applied to convert the multi-resolution feature maps to the continuous domain and make all primal confidence score maps have the same spatial resolution. Then, we exploit an efficient ensemble post-processor based on relative entropy, which can coalesce primal confidence score maps and create an optimal confidence score map for more accurate localization. The target is localized on the peak of the optimal confidence score map. Besides, we introduce a collaborative optimization strategy to update circular and structural operators by iteratively training structural correlation filters, which significantly reduces computational complexity and improves robustness. Experimental results demonstrate that our approach achieves state-of-the-art performance in mean AUC scores of 71.5 and 69.4 on the OTB2013 and OTB2015 benchmarks respectively, and obtains a third-best expected average overlap (EAO) score of 29.8 on the VOT2017 benchmark.