This work presents the first large-scale neutral benchmark experiment focused on single-event, right-censored, low-dimensional survival data. Benchmark experiments are essential in methodological research to scientifically compare new and existing model classes through proper empirical evaluation. Existing benchmarks in the survival literature are often narrow in scope, focusing, for example, on high-dimensional data. Additionally, they may lack appropriate tuning or evaluation procedures, or are qualitative reviews, rather than quantitative comparisons. This comprehensive study aims to fill the gap by neutrally evaluating a broad range of methods and providing generalizable conclusions. We benchmark 18 models, ranging from classical statistical approaches to many common machine learning methods, on 32 publicly available datasets. The benchmark tunes for both a discrimination measure and a proper scoring rule to assess performance in different settings. Evaluating on 8 survival metrics, we assess discrimination, calibration, and overall predictive performance of the tested models. Using discrimination measures, we find that no method significantly outperforms the Cox model. However, (tuned) Accelerated Failure Time models were able to achieve significantly better results with respect to overall predictive performance as measured by the right-censored log-likelihood. Machine learning methods that performed comparably well include Oblique Random Survival Forests under discrimination, and Cox-based likelihood-boosting under overall predictive performance. We conclude that for predictive purposes in the standard survival analysis setting of low-dimensional, right-censored data, the Cox Proportional Hazards model remains a simple and robust method, sufficient for practitioners.

Survival Analysis provides critical insights for partially incomplete time-to-event data in various domains. It is also an important example of probabilistic machine learning. The probabilistic nature of the predictions can be exploited by using (proper) scoring rules in the model fitting process instead of likelihood-based optimization. Our proposal does so in a generic manner and can be used for a variety of model classes. We establish different parametric and non-parametric sub-frameworks that allow different degrees of flexibility. Incorporated into neural networks, it leads to a computationally efficient and scalable optimization routine, yielding state-of-the-art predictive performance. Finally, we show that using our framework, we can recover various parametric models and demonstrate that optimization works equally well when compared to likelihood-based methods.

Survival analysis (SA), or equivalently time-to-event analysis, comprises a set of techniques enabling the unbiased estimation of the distribution of outcome variables that are partially censored, truncated, or both. Usually, the outcome is given by the time until the occurrence of an event such as death, system failure, or time to remission. Non-parametric methods like the Kaplan-Meier estimator [1] are baseline tools still used today, yet semi-parametric methods received the most attention historically, in particular the Cox proportional hazards regression model [2] and its extensions. Since the early 2000s, Machine Learning (ML) methods have been successfully adapted to survival tasks: e.g., Random Survival Forest [3] and boosting-based methods [4]. These methods often outperform traditional statistical models in terms of predictive power [5] (see [6] and [7] for detailed discussions). Neural networks (NNs) had already been applied to survival tasks in the 1990s [8, 9], but were shallow and restricted to the most standard survival settings.

Estimating the generalization error (GE) of machine learning models is fundamental, with resampling methods being the most common approach. However, in non-standard settings, particularly those where observations are not independently and identically distributed, resampling using simple random data divisions may lead to biased GE estimates. This paper strives to present well-grounded guidelines for GE estimation in various such non-standard settings: clustered data, spatial data, unequal sampling probabilities, concept drift, and hierarchically structured outcomes. Our overview combines well-established methodologies with other existing methods that, to our knowledge, have not been frequently considered in these particular settings. A unifying principle among these techniques is that the test data used in each iteration of the resampling procedure should reflect the new observations to which the model will be applied, while the training data should be representative of the entire data set used to obtain the final model. Beyond providing an overview, we address literature gaps by conducting simulation studies. These studies assess the necessity of using GE-estimation methods tailored to the respective setting. Our findings corroborate the concern that standard resampling methods often yield biased GE estimates in non-standard settings, underscoring the importance of tailored GE estimation.

Neural processes (NPs) are models for transfer learning with properties reminiscent of Gaussian Processes (GPs). They are adept at modelling data consisting of few observations of many related functions on the same input space and are trained by minimizing a variational objective, which is computationally much less expensive than the Bayesian updating required by GPs. So far, most studies of NPs have focused on low-dimensional datasets which are not representative of realistic transfer learning tasks. Drug discovery is one application area that is characterized by datasets consisting of many chemical properties or functions which are sparsely observed, yet depend on shared features or representations of the molecular inputs. This paper applies the conditional neural process (CNP) to DOCKSTRING, a dataset of docking scores for benchmarking ML models. CNPs show competitive performance in few-shot learning tasks relative to supervised learning baselines common in chemoinformatics, as well as an alternative model for transfer learning based on pre-training and refining neural network regressors. We present a Bayesian optimization experiment which showcases the probabilistic nature of CNPs and discuss shortcomings of the model in uncertainty quantification.

The estimation of heterogeneous treatment effects (HTEs) has attracted considerable interest in many disciplines, most prominently in medicine and economics. Contemporary research has so far primarily focused on continuous and binary responses where HTEs are traditionally estimated by a linear model, which allows the estimation of constant or heterogeneous effects even under certain model misspecifications. More complex models for survival, count, or ordinal outcomes require stricter assumptions to reliably estimate the treatment effect. Most importantly, the noncollapsibility issue necessitates the joint estimation of treatment and prognostic effects. Model-based forests allow simultaneous estimation of covariate-dependent treatment and prognostic effects, but only for randomized trials. In this paper, we propose modifications to model-based forests to address the confounding issue in observational data. In particular, we evaluate an orthogonalization strategy originally proposed by Robinson (1988, Econometrica) in the context of model-based forests targeting HTE estimation in generalized linear models and transformation models. We found that this strategy reduces confounding effects in a simulated study with various outcome distributions. We demonstrate the practical aspects of HTE estimation for survival and ordinal outcomes by an assessment of the potentially heterogeneous effect of Riluzole on the progress of Amyotrophic Lateral Sclerosis.

Survival analysis (SA) is an active field of research that is concerned with time-to-event outcomes and is prevalent in many domains, particularly biomedical applications. Despite its importance, SA remains challenging due to small-scale data sets and complex outcome distributions, concealed by truncation and censoring processes. The piecewise exponential additive mixed model (PAMM) is a model class addressing many of these challenges, yet PAMMs are not applicable in high-dimensional feature settings or in the case of unstructured or multimodal data. We unify existing approaches by proposing DeepPAMM, a versatile deep learning framework that is well-founded from a statistical point of view, yet with enough flexibility for modeling complex hazard structures. We illustrate that DeepPAMM is competitive with other machine learning approaches with respect to predictive performance while maintaining interpretability through benchmark experiments and an extended case study.

In this paper we consider how to evaluate survival distribution predictions with measures of discrimination. This is a non-trivial problem as discrimination measures are the most commonly used in survival analysis and yet there is no clear method to derive a risk prediction from a distribution prediction. We survey methods proposed in literature and software and consider their respective advantages and disadvantages. Whilst distributions are frequently evaluated by discrimination measures, we find that the method for doing so is rarely described in the literature and often leads to unfair comparisons. We find that the most robust method of reducing a distribution to a risk is to sum over the predicted cumulative hazard. We recommend that machine learning survival analysis software implements clear transformations between distribution and risk predictions in order to allow more transparent and accessible model evaluation.

The field of machine learning for drug discovery is witnessing an explosion of novel methods. These methods are often benchmarked on simple physicochemical properties such as solubility or general druglikeness, which can be readily computed. However, these properties are poor representatives of objective functions in drug design, mainly because they do not depend on the candidate's interaction with the target. By contrast, molecular docking is a widely successful method in drug discovery to estimate binding affinities. However, docking simulations require a significant amount of domain knowledge to set up correctly which hampers adoption. To this end, we present DOCKSTRING, a bundle for meaningful and robust comparison of ML models consisting of three components: (1) an open-source Python package for straightforward computation of docking scores; (2) an extensive dataset of docking scores and poses of more than 260K ligands for 58 medically-relevant targets; and (3) a set of pharmaceutically-relevant benchmark tasks including regression, virtual screening, and de novo design. The Python package implements a robust ligand and target preparation protocol that allows non-experts to obtain meaningful docking scores. Our dataset is the first to include docking poses, as well as the first of its size that is a full matrix, thus facilitating experiments in multiobjective optimization and transfer learning. Overall, our results indicate that docking scores are a more appropriate evaluation objective than simple physicochemical properties, yielding more realistic benchmark tasks and molecular candidates.

We propose a versatile framework for survival analysis that combines advanced concepts from statistics with deep learning. The presented framework is based on piecewise exponential models and thereby supports various survival tasks, such as competing risks and multi-state modeling, and further allows for estimation of time-varying effects and time-varying features. To also include multiple data sources and higher-order interaction effects into the model, we embed the model class in a neural network and thereby enable the simultaneous estimation of both inherently interpretable structured regression inputs as well as deep neural network components which can potentially process additional unstructured data sources. A proof of concept is provided by using the framework to predict Alzheimer's disease progression based on tabular and 3D point cloud data and applying it to synthetic data.