We investigate the effect of the proportional hazards assumption on prognostic and predictive models of the survival time of patients suffering from amyotrophic lateral sclerosis (ALS). We theoretically compare the underlying model formulations of several variants of survival forests and implementations thereof, including random forests for survival, conditional inference forests, Ranger, and survival forests with $L_1$ splitting, with two novel variants, namely distributional and transformation survival forests. Theoretical considerations explain the low power of log-rank-based splitting in detecting patterns in non-proportional hazards situations in survival trees and corresponding forests. This limitation can potentially be overcome by the alternative split procedures suggested herein. We empirically investigated this effect using simulation experiments and a re-analysis of the PRO-ACT database of ALS survival, giving special emphasis to both prognostic and predictive models.
In this paper, we expand the methodology presented in Mertens et. al (2020, Biometrical Journal) to the study of life-time (survival) outcome which is subject to censoring and when imputation is used to account for missing values. We consider the problem where missing values can occur in both the calibration data as well as newly - to-be-predicted - observations (validation). We focus on the Cox model. Methods are described to combine imputation with predictive calibration in survival modeling subject to censoring. Application to cross-validation is discussed. We demonstrate how conclusions br…
In observational studies of survival time featuring a binary time-dependent treatment, the hazard ratio (an instantaneous measure) is often used to represent the treatment effect. However, investigators are often more interested in the difference in survival functions. We propose semiparametric methods to estimate the causal effect of treatment among the treated with respect to survival probability. The objective is to compare post-treatment survival with the survival function that would have been observed in the absence of treatment. For each patient, we compute a prognostic score (based on t…
Recent work on follow the perturbed leader (FTPL) algorithms for the adversarial multi-armed bandit problem has highlighted the role of the hazard rate of the distribution generating the perturbations. Assuming that the hazard rate is bounded, it is possible to provide regret analyses for a variety of FTPL algorithms for the multi-armed bandit problem. This paper pushes the inquiry into regret bounds for FTPL algorithms beyond the bounded hazard rate condition. There are good reasons to do so: natural distributions such as the uniform and Gaussian violate the condition. We give regret bounds f…
Survival models are used to analyze time-to-event data in a variety of disciplines. Proportional hazard models provide interpretable parameter estimates, but proportional hazards assumptions are not always appropriate. Non-parametric models are more flexible but often lack a clear inferential framework. We propose a Bayesian tree partition model which is both flexible and inferential. Inference is obtained through the posterior tree structure and flexibility is preserved by modeling the the hazard function in each partition using a latent exponentiated Gaussian process. An efficient reversible…
Identification of biomarkers is an emerging area in Oncology. In this article, we develop an efficient statistical procedure for classification of protein markers according to their effect on cancer progression. A high-dimensional time-course dataset of protein markers for 80 patients motivates us for developing the model. We obtain the optimal threshold values for markers using Cox proportional hazard model. The optimal threshold value is defined as a level of a marker having maximum impact on cancer progression. The classification was validated by comparing random components using both propo…
In the process of clinical diagnosis and treatment, the restricted mean survival time (RMST), which reflects the life expectancy of patients up to a specified time, can be used as an appropriate outcome measure. However, the RMST only calculates the mean survival time of patients within a period of time after the start of follow-up and may not accurately portray the change in a patient's life expectancy over time. The life expectancy can be adjusted for the time the patient has already survived and defined as the conditional restricted mean survival time (cRMST). A dynamic RMST model based on …
We present a new estimator of the restricted mean survival time in randomized trials where there is right censoring that may depend on treatment and baseline variables. The proposed estimator leverages prognostic baseline variables to obtain equal or better asymptotic precision compared to traditional estimators. Under regularity conditions and random censoring within strata of treatment and baseline variables, the proposed estimator has the following features: (i) it is interpretable under violations of the proportional hazards assumption; (ii) it is consistent and at least as precise as the …
In clinical trials, identification of prognostic and predictive biomarkers is essential to precision medicine. Prognostic biomarkers can be useful for the prevention of the occurrence of the disease, and predictive biomarkers can be used to identify patients with potential benefit from the treatment. Previous researches were mainly focused on clinical characteristics, and the use of genomic data in such an area is hardly studied. A new method is required to simultaneously select prognostic and predictive biomarkers in high dimensional genomic data where biomarkers are highly correlated. We pro…
Observing the unobserved confounding through its effects: toward randomized trial-like estimates from real-world survival data
Operations Research Center, Massachusetts Institute of Technology（麻省理工学院运营研究中心）；Sloan School of Management, Massachusetts Institute of Technology（麻省理工学院斯隆管理学院）；Department of Surgery, Memorial Sloan Kettering Cancer Center（纪念斯隆凯特琳癌症中心外科部）；Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin（柏林夏里特医学院，柏林自由大学和洪堡大学联合成员）
Maximum approximate Bernstein likelihood estimates of the baseline density function and the regression coefficients in the proportional hazard regression models based on interval-censored event time data are proposed. This results in not only a smooth estimate of the survival function which enjoys faster convergence rate but also improved estimates of the regression coefficients. Simulation shows that the finite sample performance of the proposed method is better than the existing ones. The proposed method is illustrated by real data applications.
Time to event outcomes are often evaluated on the hazard scale, but interpreting hazards may be difficult. Recently, there has been concern in the causal inference literature that hazards actually have a built in selection-effect that prevents simple causal interpretations. This is even a problem in randomized controlled trials, where hazard ratios have become a standard measure of treatment effects. Modeling on the hazard scale is nevertheless convenient, e.g. to adjust for covariates. Using hazards for intermediate calculations may therefore be desirable. Here, we provide a generic method fo…
This paper considers the problem of semi-parametric proportional hazards model fitting for interval, left and right censored survival times. We adopt a more versatile penalized likelihood method to estimate the baseline hazard and the regression coefficients simultaneously, where the penalty is introduced in order to regularize the baseline hazard estimate. We present asymptotic properties of our estimate, allowing for the possibility that it may lie on the boundary of the parameter space. We also provide a computational method based on marginal likelihood, which allows the regularization para…
In biometrics and related fields, the Cox proportional hazards model are widely used to analyze with covariate adjustment. However, when some covariates are not observed, an unbiased estimator usually cannot be obtained. Even if there are some unmeasured covariates, instrumental variable methods can be applied under some assumptions. In this paper, we propose the new instrumental variable estimator for the Cox proportional hazards model. The estimator is the similar feature as Martinez-Camblor et al., 2019, but not the same exactly; we use an idea of limited-information maximum likelihood. We …
The Cox regression, a semi-parametric method of survival analysis, is extremely popular in biomedical applications. The proportional hazards assumption is a key requirement in the Cox model. To accommodate non-proportional hazards, we propose to parameterise the shape parameter of the baseline hazard function using the additional, separate Cox-regression term which depends on the vector of the covariates. We call this model the double-Cox model. The R programs for fitting the double-Cox model are available on Github. We formally introduce the double-Cox model with shared frailty and investigat…
The semi-parametric Cox proportional hazards regression model has been widely used for many years in several applied sciences. However, a fully parametric proportional hazards model, if appropriately assumed, can often lead to more efficient inference. To tackle the extreme non-robustness of the traditional maximum likelihood estimator in the presence of outliers in the data under such fully parametric proportional hazard models, a robust estimation procedure has recently been proposed extending the concept of the minimum density power divergence estimator (MDPDE) under this set-up. In this pa…
In survival analysis, Cox model is widely used for most clinical trial data. Alternatives include the additive hazard model, the accelerated failure time (AFT) model and a more general transformation model. All these models assume that the effects for all covariates are on the same scale. However, it is possible that for different covariates, the effects are on different scales. In this paper, we propose a shape-invariant hazard regression model that allows us to estimate the multiplicative treatment effect with adjustment of covariates that have non-multiplicative effects. We propose moment-b…
\noindent Randomized nomination sampling (RNS) is a rank-based sampling technique which has been shown to be effective in several nonparametric studies involving environmental and ecological applications. In this paper, we investigate parametric inference using RNS design for estimating the unknown vector of parameters $\boldsymbolθ$ in the proportional hazard rate and proportional reverse hazard rate models. We examine both maximum likelihood (ML) and method of moments (MM) methods and investigate the relative precision of our proposed RNS-based estimators compared with those based on simple …
