Functional survival models are key tools for analyzing time-to-event data with complex predictors, such as functional or high-dimensional inputs. Despite their predictive strength, these models often lack interpretability, which limits their value in practical decision-making and risk analysis. This study investigates two key survival models: the Functional Survival Tree (FST) and the Functional Random Survival Forest (FRSF). It introduces novel methods and tools to enhance the interpretability of FST models and improve the explainability of FRSF ensembles. Using both real and simulated datasets, the results demonstrate that the proposed approaches yield efficient, easy-to-understand decision trees that accurately capture the underlying decision-making processes of the model ensemble.

Deep learning survival models often outperform classical methods in time-to-event predictions, particularly in personalized medicine, but their "black box" nature hinders broader adoption. We propose a framework for gradient-based explanation methods tailored to survival neural networks, extending their use beyond regression and classification. We analyze the implications of their theoretical assumptions for time-dependent explanations in the survival setting and propose effective visualizations incorporating the temporal dimension. Experiments on synthetic data show that gradient-based methods capture the magnitude and direction of local and global feature effects, including time dependencies. We introduce GradSHAP(t), a gradient-based counterpart to SurvSHAP(t), which outperforms SurvSHAP(t) and SurvLIME in a computational speed vs. accuracy trade-off. Finally, we apply these methods to medical data with multi-modal inputs, revealing relevant tabular features and visual patterns, as well as their temporal dynamics.

Summary: Due to their flexibility and superior performance, machine learning models frequently complement and outperform traditional statistical survival models. However, their widespread adoption is hindered by a lack of user-friendly tools to explain their internal operations and prediction rationales. To tackle this issue, we introduce the survex R package, which provides a cohesive framework for explaining any survival model by applying explainable artificial intelligence techniques. The capabilities of the proposed software encompass understanding and diagnosing survival models, which can lead to their improvement. By revealing insights into the decision-making process, such as variable effects and importances, survex enables the assessment of model reliability and the detection of biases. Thus, transparency and responsibility may be promoted in sensitive areas, such as biomedical research and healthcare applications.

Machine and deep learning survival models demonstrate similar or even improved time-to-event prediction capabilities compared to classical statistical learning methods yet are too complex to be interpreted by humans. Several model-agnostic explanations are available to overcome this issue; however, none directly explain the survival function prediction. In this paper, we introduce SurvSHAP(t), the first time-dependent explanation that allows for interpreting survival black-box models. It is based on SHapley Additive exPlanations with solid theoretical foundations and a broad adoption among machine learning practitioners. The proposed methods aim to enhance precision diagnostics and support domain experts in making decisions. Experiments on synthetic and medical data confirm that SurvSHAP(t) can detect variables with a time-dependent effect, and its aggregation is a better determinant of the importance of variables for a prediction than SurvLIME. SurvSHAP(t) is model-agnostic and can be applied to all models with functional output. We provide an accessible implementation of time-dependent explanations in Python at http://github.com/MI2DataLab/survshap.

Machine and deep learning survival models demonstrate similar or even improved time-to-event prediction capabilities compared to classical statistical learning methods yet are too complex to be interpreted by humans. Several model-agnostic explanations are available to overcome this issue; however, none directly explain the survival function prediction. In this paper, we introduce SurvSHAP(t), the first time-dependent explanation that allows for interpreting survival black-box models. It is based on SHapley Additive exPlanations with solid theoretical foundations and a broad adoption among machine learning practitioners. The proposed methods aim to enhance precision diagnostics and support domain experts in making decisions. Experiments on synthetic and medical data confirm that SurvSHAP(t) can detect variables with a time-dependent effect, and its aggregation is a better determinant of the importance of variables for a prediction than SurvLIME. SurvSHAP(t) is model-agnostic and can be applied to all models with functional output. We provide an accessible implementation of time-dependent explanations in Python at http://github.com/MI2DataLab/survshap .