Survival analysis is a critical tool for modeling time-to-event data. Recent deep learning-based models have reduced various modeling assumptions including proportional hazard and linearity. However, a persistent challenge remains in incorporating longitudinal covariates, with prior work largely focusing on cross-sectional features, and in assessing calibration of these models, with research primarily focusing on discrimination during evaluation. We introduce TraCeR, a transformer-based survival analysis framework for incorporating longitudinal covariates. Based on a factorized self-attention architecture, TraCeR estimates the hazard function from a sequence of measurements, naturally capturing temporal covariate interactions without assumptions about the underlying data-generating process. The framework is inherently designed to handle censored data and competing events. Experiments on multiple real-world datasets demonstrate that TraCeR achieves substantial and statistically significant performance improvements over state-of-the-art methods. Furthermore, our evaluation extends beyond discrimination metrics and assesses model calibration, addressing a key oversight in literature.

Survival analysis often relies on Cox models, assuming both linearity and proportional hazards (PH). This study evaluates machine and deep learning methods that relax these constraints, comparing their performance with penalized Cox models on a benchmark of three synthetic and three real datasets. In total, eight different models were tested, including six non-linear models of which four were also non-PH. Although Cox regression often yielded satisfactory performance, we showed the conditions under which machine and deep learning models can perform better. Indeed, the performance of these methods has often been underestimated due to the improper use of Harrell's concordance index (C-index) instead of more appropriate scores such as Antolini's concordance index, which generalizes C-index in cases where the PH assumption does not hold. In addition, since occasionally high C-index models happen to be badly calibrated, combining Antolini's C-index with Brier's score is useful to assess the overall performance of a survival method. Results on our benchmark data showed that survival prediction should be approached by testing different methods to select the most appropriate one according to sample size, non-linearity and non-PH conditions. To allow an easy reproducibility of these tests on our benchmark data, code and documentation are freely available at https://github.com/compbiomed-unito/survhive.

When dealing with right-censored data, where some outcomes are missing due to a limited observation period, survival analysis -- known as time-to-event analysis -- focuses on predicting the time until an event of interest occurs. Multiple classes of outcomes lead to a classification variant: predicting the most likely event, a less explored area known as competing risks. Classic competing risks models couple architecture and loss, limiting scalability.To address these issues, we design a strictly proper censoring-adjusted separable scoring rule, allowing optimization on a subset of the data as each observation is evaluated independently. The loss estimates outcome probabilities and enables stochastic optimization for competing risks, which we use for efficient gradient boosting trees. SurvivalBoost not only outperforms 12 state-of-the-art models across several metrics on 4 real-life datasets, both in competing risks and survival settings, but also provides great calibration, the ability to predict across any time horizon, and computation times faster than existing methods.

When data are right-censored, i.e. some outcomes are missing due to a limited period of observation, survival analysis can compute the "time to event". Multiple classes of outcomes lead to a classification variant: predicting the most likely event, known as competing risks, which has been less studied. To build a loss that estimates outcome probabilities for such settings, we introduce a strictly proper censoring-adjusted separable scoring rule that can be optimized on a subpart of the data because the evaluation is made independently of observations. It enables stochastic optimization for competing risks which we use to train gradient boosting trees. Compared to 11 state-of-the-art models, this model, MultiIncidence, performs best in estimating the probability of outcomes in survival and competing risks. It can predict at any time horizon and is much faster than existing alternatives.

The accurate prediction of survival times for patients with severe diseases remains a critical challenge despite recent advances in artificial intelligence. This study introduces "SurvTimeSurvival: Survival Analysis On Patients With Multiple Visits/Records", utilizing the Transformer model to not only handle the complexities of time-varying covariates but also covariates data. We also tackle the data sparsity issue common to survival analysis datasets by integrating synthetic data generation into the learning process of our model. We show that our method outperforms state-of-the-art deep learning approaches on both covariates and time-varying covariates datasets. Our approach aims not only to enhance the understanding of individual patient survival trajectories across various medical conditions, thereby improving prediction accuracy, but also to play a pivotal role in designing clinical trials and creating new treatments.

In medicine, survival analysis studies the time duration to events of interest such as mortality. One major challenge is how to deal with multiple competing events (e.g., multiple disease diagnoses). In this work, we propose a transformer-based model that does not make the assumption for the underlying survival distribution and is capable of handling competing events, namely SurvTRACE. We account for the implicit \emph{confounders} in the observational setting in multi-events scenarios, which causes selection bias as the predicted survival probability is influenced by irrelevant factors. To sufficiently utilize the survival data to train transformers from scratch, multiple auxiliary tasks are designed for multi-task learning. The model hence learns a strong shared representation from all these tasks and in turn serves for better survival analysis. We further demonstrate how to inspect the covariate relevance and importance through interpretable attention mechanisms of SurvTRACE, which suffices to great potential in enhancing clinical trial design and new treatment development. Experiments on METABRIC, SUPPORT, and SEER data with 470k patients validate the all-around superiority of our method.