In cancer research, overall survival and progression free survival are often analyzed with the Cox model. To estimate accurately the parameters in the model, sufficient data and, more importantly, sufficient events need to be observed. In practice, this is often a problem. Merging data sets from different medical centers may help, but this is not always possible due to strict privacy legislation and logistic difficulties. Recently, the Bayesian Federated Inference (BFI) strategy for generalized linear models was proposed. With this strategy the statistical analyses are performed in the local centers where the data were collected (or stored) and only the inference results are combined to a single estimated model; merging data is not necessary. The BFI methodology aims to compute from the separate inference results in the local centers what would have been obtained if the analysis had been based on the merged data sets. In this paper we generalize the BFI methodology as initially developed for generalized linear models to survival models. Simulation studies and real data analyses show excellent performance; i.e., the results obtained with the BFI methodology are very similar to the results obtained by analyzing the merged data. An R package for doing the analyses is available.

The discussion on causality in human history dates back to ancient Greece, yet to this day, there is still no consensus. Fundamentally, this stems from the nature of human cognition, as understanding causality requires abstract tools to transcend the limitations of human cognition. In recent decades, the rapid development of mathematical and computational tools has provided new theoretical and technical means for exploring causality, creating more avenues for investigation. Based on this, this paper introduces a new definition of causality using category theory, proposed by Samuel Eilenberg and Saunders Mac Lane in 1945 to avoid the self-referential contradictions in set theory, notably the Russell paradox. Within this framework, the feasibility of indicator synthesis in causal inference is demonstrated. Due to the limitations in the development of category theory-related technical tools, this paper adopts the widely-used probabilistic causal graph tool proposed by Judea Pearl in 1995 to study the application of causal inference in personal credit risk management. The specific work includes: research on the construction method of causal inference index system, definition of causality and feasibility proof of indicator synthesis causal inference within this framework, application methods of causal graph model and intervention alternative criteria in personal credit risk management, and so on.

Objective: To improve survival analysis using EHR data, we aim to develop a supervised topic model called MixEHR-SurG to simultaneously integrate heterogeneous EHR data and model survival hazard. Materials and Methods: Our technical contributions are three-folds: (1) integrating EHR topic inference with Cox proportional hazards likelihood; (2) inferring patient-specific topic hyperparameters using the PheCode concepts such that each topic can be identified with exactly one PheCode-associated phenotype; (3) multi-modal survival topic inference. This leads to a highly interpretable survival and guided topic model that can infer PheCode-specific phenotype topics associated with patient mortality. We evaluated MixEHR-G using a simulated dataset and two real-world EHR datasets: the Quebec Congenital Heart Disease (CHD) data consisting of 8,211 subjects with 75,187 outpatient claim data of 1,767 unique ICD codes; the MIMIC-III consisting of 1,458 subjects with multi-modal EHR records. Results: Compared to the baselines, MixEHR-G achieved a superior dynamic AUROC for mortality prediction, with a mean AUROC score of 0.89 in the simulation dataset and a mean AUROC of 0.645 on the CHD dataset. Qualitatively, MixEHR-G associates severe cardiac conditions with high mortality risk among the CHD patients after the first heart failure hospitalization and critical brain injuries with increased mortality among the MIMIC-III patients after their ICU discharge. Conclusion: The integration of the Cox proportional hazards model and EHR topic inference in MixEHR-SurG led to not only competitive mortality prediction but also meaningful phenotype topics for systematic survival analysis. The software is available at GitHub: https://github.com/li-lab-mcgill/MixEHR-SurG.

Time-to-event analysis, also known as survival analysis, aims to predict the time of occurrence of an event, given a set of features. One of the major challenges in this area is dealing with censored data, which can make learning algorithms more complex. Traditional methods such as Cox's proportional hazards model and the accelerated failure time (AFT) model have been popular in this field, but they often require assumptions such as proportional hazards and linearity. In particular, the AFT models often require pre-specified parametric distributional assumptions. To improve predictive performance and alleviate strict assumptions, there have been many deep learning approaches for hazard-based models in recent years. However, representation learning for AFT has not been widely explored in the neural network literature, despite its simplicity and interpretability in comparison to hazard-focused methods. In this work, we introduce the Deep AFT Rank-regression model for Time-to-event prediction (DART). This model uses an objective function based on Gehan's rank statistic, which is efficient and reliable for representation learning. On top of eliminating the requirement to establish a baseline event time distribution, DART retains the advantages of directly predicting event time in standard AFT models. The proposed method is a semiparametric approach to AFT modeling that does not impose any distributional assumptions on the survival time distribution. This also eliminates the need for additional hyperparameters or complex model architectures, unlike existing neural network-based AFT models. Through quantitative analysis on various benchmark datasets, we have shown that DART has significant potential for modeling high-throughput censored time-to-event data.

Prognostication for lung cancer, a leading cause of mortality, remains a complex task, as it needs to quantify the associations of risk factors and health events spanning a patient's entire life. One challenge is that an individual's disease course involves non-terminal (e.g., disease progression) and terminal (e.g., death) events, which form semi-competing relationships. Our motivation comes from the Boston Lung Cancer Study, a large lung cancer survival cohort, which investigates how risk factors influence a patient's disease trajectory. Following developments in the prediction of time-to-event outcomes with neural networks, deep learning has become a focal area for the development of risk prediction methods in survival analysis. However, limited work has been done to predict multi-state or semi-competing risk outcomes, where a patient may experience adverse events such as disease progression prior to death. We propose a novel neural expectation-maximization algorithm to bridge the gap between classical statistical approaches and machine learning. Our algorithm enables estimation of the non-parametric baseline hazards of each state transition, risk functions of predictors, and the degree of dependence among different transitions, via a multi-task deep neural network with transition-specific sub-architectures. We apply our method to the Boston Lung Cancer Study and investigate the impact of clinical and genetic predictors on disease progression and mortality.

Survival analysis is a critical tool for the modelling of time-to-event data, such as life expectancy after a cancer diagnosis or optimal maintenance scheduling for complex machinery. However, current neural network models provide an imperfect solution for survival analysis as they either restrict the shape of the target probability distribution or restrict the estimation to pre-determined times. As a consequence, current survival neural networks lack the ability to estimate a generic function without prior knowledge of its structure. In this article, we present the metaparametric neural network framework that encompasses existing survival analysis methods and enables their extension to solve the aforementioned issues. This framework allows survival neural networks to satisfy the same independence of generic function estimation from the underlying data structure that characterizes their regression and classification counterparts. Further, we demonstrate the application of the metaparametric framework using both simulated and large real-world datasets and show that it outperforms the current state-of-the-art methods in (i) capturing nonlinearities, and (ii) identifying temporal patterns, leading to more accurate overall estimations whilst placing no restrictions on the underlying function structure.

We consider the problem of constructing diffusion operators high dimensional data $X$ to address counterfactual functions $F$, such as individualized treatment effectiveness. We propose and construct a new diffusion metric $K_F$ that captures both the local geometry of $X$ and the directions of variance of $F$. The resulting diffusion metric is then used to define a localized filtration of $F$ and answer counterfactual questions pointwise, particularly in situations such as drug trials where an individual patient's outcomes cannot be studied long term both taking and not taking a medication. We validate the model on synthetic and real world clinical trials, and create individualized notions of benefit from treatment.

This paper proposes a decorrelation-based approach to test hypotheses and construct confidence intervals for the low dimensional component of high dimensional proportional hazards models. Motivated by the geometric projection principle, we propose new decorrelated score, Wald and partial likelihood ratio statistics. Without assuming model selection consistency, we prove the asymptotic normality of these test statistics, establish their semiparametric optimality. We also develop new procedures for constructing pointwise confidence intervals for the baseline hazard function and baseline survival function. Thorough numerical results are provided to back up our theory.