arXiv:2504.17568cs.LGq-bio.QM2025-04被引 6

对比机器学习在非比例风险与非线性生存分析中的表现,揭示其优势场景。

Beyond Cox Models: Assessing the Performance of Machine-Learning Methods in Non-Proportional Hazards and Non-Linear Survival Analysis

  • 采用八种模型对比,包括四类非线性非比例风险方法。
  • 发现传统C-index会低估机器学习效果,应改用Antolini's C-index。
  • 建议结合Brier得分评估整体性能,适合医学预测研究者使用。

生存分析常依赖Cox模型,但其假设线性关系和比例风险(PH)。本研究评估了可放宽这些限制的机器与深度学习方法,在三个合成数据集和三个真实数据集上的表现,并与正则化Cox模型进行比较。共测试八种模型,其中六种为非线性,四类亦非比例风险。尽管Cox回归通常表现良好,但在非线性或非比例风险条件下,机器学习方法表现更优。以往研究常因误用哈雷尔的C-index而低估其效果,该指标在不满足PH时失效;应改用推广的Antolini's C-index。此外,高C-index模型可能校准差,结合Brier得分可全面评估性能。结果表明,应根据样本量、非线性程度和是否违反PH条件,选择最适方法。代码与文档已公开于https://github.com/compbiomed-unito/survhive,便于复现。

原文摘要 · Abstract (English)

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.

生存分析机器学习非比例风险模型评估

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